抗菌药物不合理用药的相关因素研究  

Study on the factors associated with irrational use of antibiotics

作　　者：姬长存 崔瑶[2] 陈雅倩[1] JI Changcun;CUI Yao;CHEN Yaqian(Department of Pharmacy,Pizhou People's Hospital,Jiangsu,Pizhou 221300,China;Department of Gastroenterology,Pizhou People's Hospital,Jiangsu,Pizhou 221300,China)

机构地区：[1]江苏省邳州市人民医院药剂科,江苏邳州221300 [2]江苏省邳州市人民医院消化内科,江苏邳州221300

出　　处：《中国医药科学》2021年第17期227-230,共4页China Medicine And Pharmacy

摘　　要：目的对抗菌药物不合理使用的相关因素进行分析,为今后抗菌药物的合理使用提供参考。方法选取2017年1月至2019年12月邳州市人民医院抗菌药物不合理处方患者186例,运用随机数字表法分为CC组(医生常规给药),HH组(分析不合理因素+药师+医生干预给药)。观察抗菌药物不合理应用的情况、抗菌药物使用种类以及患者疗效与不良反应。结果在不合理使用的多种因素中,超剂量、超广谱、用药时间不合理是发生率较大的因素。在抗菌药物的多种药物种类中,头孢菌素类构成比为41.93%,是本研究中不合理使用概率最高的药物。在不合理使用抗菌药物的患者中,经过干预后,HH组的有效率为95.70%,高于CC组的84.95%,差异有统计学意义(P<0.05);HH组不良反应为2.15%,低于CC组的9.68%,差异有统计学意义(P<0.05)。不良反应主要分布在皮肤软组织中,比例为56.98%,其次是胃肠道及心血管中,少量存在神经系统及呼吸系统中。结论在抗菌药物的使用中,以头孢菌素类、青霉素类不合理使用率最高,导致抗菌药物不合理使用的主要因素是用药时间不合理、超广谱及超剂量用药,患者不合理用药所产生的不良反应主要集中在皮肤软组织及胃肠道,分析不合理因素患者治疗效果更优,不良反应较少,安全性较高。Objective To analyze the factors related to the irrational use of antibiotics,so as to provide reference for the rational use of antibiotics in the future.Methods A total of 186 patients with irrational prescription of antibiotics in Pizhou People's Hospital from January 2017 to December 2019 were selected as study objects and divided into the CC group(conventional administration by doctors)and the HH group(analysis of irrational factors+pharmacist+intervention in administration by doctors)by using the random number method.The irrational use of antibiotics,the types of antibiotics used,and the efficacy and adverse reactions(ARs)of patients were compared.Results Among the multiple factors for irrational use,overdose,extended spectrum,and irrational time of administration were the factors frequently presented.Among the multiple types of antibiotics,the composition ratio of cephalosporins was 41.93%,which was the drug with the highest probability of the irrational use of antibiotics in this study.Among the patients with irrational use of antibiotics,the effective rate of the HH group after the intervention was 95.70%,which was higher than 84.95%of the CC group,with statistically significant difference(P<0.05).The incidence of adverse reactions ARs in the HH group was 2.15%,which was lower than 9.68%of the CC group,with statistically significant difference(P<0.05).The proportion of ARs mainly distributed in the soft tissue of the skin was 56.98%,followed by the gastrointestinal tract and cardiovascular,and a small amount existed in the nervous system and respiratory system.Conclusion In the use of antibiotics,cephalosporins and penicillins are the most commonly used irrationally,and the main factors resulting in the improper use of antibiotics are irrational time of administration,extended spectrum and overdose of drugs.The ARs caused by the patients'irrational use of drugs are mainly concentrated in the soft tissue of skin and gastrointestinal tract.Through analyzing of irrational factors for drug use,the better eff

关 键 词：抗菌药物 不合理用药 时间因素 超剂量用药 

分 类 号：R95[医药卫生—药学]