江苏省15家医院极低/超低出生体重儿抗生素使用现状调查  

Antibiotic use in very low birth weight/extremely low birth weight infants in 15 hospitals in Jiangsu Province of China:a multicenter survey

作　　者：赵娟娟 韩树萍[1] 余章斌[1] 潘兆军[2] 周勤[3] 姜善雨[3] 万俊[4] 张琳 王淮燕 孟孟 徐艳 陈筱青 薛梅[8] 杨丽[8] 吴明赴[9] 顾瓅[10] 卢红艳[11] 乔瑜 吴新萍[12] 谷传丽 侯玮玮 高艳[14] 仰守红[14] 张纪华[15] 刘松林[15] ZHAO Juan-Juan;HAN Shu-Ping;YU Zhang-Bin;PAN Zhao-Juan;ZHOU Qin;JIANG Shan-Yu;WAN Jun;ZHANG Lin;WANG Huai-Yan;MENG Meng;XU Yan;CHEN Xiao-Qing;XUE Mei;YANG Li;WU Ming-Fu;GU Li;LU Hong-Yan;QIAO Yu;WU Xin-Ping;GU Chuan-Li;HOU Wei-Wei;GAO Yan;YANG Shou-Hong;ZHANG Ji-Hua;LIU Song-Lin(Department of Neonatology,Women's Hospital of Nanjing Medical University/Nanjing Maternity and Child Health Care Hospital,Nanjing 210004)

机构地区：[1]南京医科大学附属妇产医院/南京市妇幼保健院新生儿科,江苏南京210004 [2]淮安市妇幼保健院新生儿科,江苏淮安223002 [3]无锡市妇幼保健院新生儿科,江苏无锡214002 [4]江阴市人民医院新生儿科,江苏江阴214400 [5]常州市妇幼保健院新生儿科,江苏常州213000 [6]徐州医科大学附属医院新生儿科,江苏徐州221002 [7]南京医科大学第一附属医院新生儿科,江苏南京210004 [8]泰州市人民医院新生儿科,江苏泰州225300 [9]扬州大学附属医院新生儿科,江苏扬州225001 [10]南通市妇幼保健院新生儿科,江苏南通226001 [11]江苏大学附属医院新生儿科,江苏镇江212000 [12]扬州市妇幼保健院新生儿科,江苏扬州225001 [13]苏北人民医院新生儿科,江苏扬州225001 [14]连云港市妇幼保健院新生儿科,江苏连云港222000 [15]徐州市妇幼保健院新生儿科,江苏徐州221009

出　　处：《中国当代儿科杂志》2022年第9期988-993,共6页Chinese Journal of Contemporary Pediatrics

基　　金：南京市医学科技发展基金(ZKX16062、YKK17176);江苏省妇幼健康科研项目(F201642);江苏省妇幼健康重点人才(FRC201740)。

摘　　要：目的调查并分析江苏省极低/超低出生体重儿抗生素使用现状,为促进新生儿重症监护室(neonatal intensive care unit,NICU)抗生素管理质量及改进提供临床依据。方法回顾性分析2019年1月1日至2020年12月31日江苏省15家医院收治的极低/超低出生体重儿的一般情况及抗生素使用情况的相关资料,并设计减少抗生素使用措施的10项调查问卷表,通过问卷调查了解干预措施的实施情况。结果共纳入1920例极低/超低出生体重儿,其中1846例(96.15%)使用抗生素,抗生素使用率(antibiotic use rate,AUR)中位数为50/100住院日。15家医院AUR为24~100/100住院日。采用Poisson回归,调整胎龄、出生体重、新生儿危重评分混杂因素后,各医院间调整后抗生素使用率(adjusted antibiotic use rate,aAUR)差异有统计学意义(P<0.01)。调查结果显示,10项减少抗生素使用的措施中,8项措施开展的医院不足一半;干预措施实施项目数与aAUR呈负相关(r_(s)=-0.564,P=0.029)。结论江苏省15家医院极低/超低出生体重儿AUR高,且医院之间差异大;实施减少抗生素使用措施少的医院AUR高,促进NICU抗生素使用管理的质量改进,有望减少极低/超低出生体重儿的AUR。Objective To investigate the current status of antibiotic use in very low birth weight/extremely low birth weight infants in Jiangsu Province of China,and to provide a clinical basis for the quality and improvement of antibiotic management in the neonatal intensive care unit(NICU).Methods A retrospective analysis was performed on the data on general conditions and antibiotic use in the very low birth weight/extremely low birth weight infants who were admitted to 15 hospitals of Jiangsu Province from January 1,2019 to December 31,2020.A questionnaire containing 10 measures to reduce antibiotic use was designed to investigate the implementation of these intervention measures.Results A total of 1920 very low birth weight/extremely low birth weight infants were enrolled,among whom 1846(96.15%)were treated with antibiotic,and the median antibiotic use rate(AUR)was 50/100 patient-days.The AUR ranged from 24/100 to 100/100 patient-days in the 15 hospitals.After adjustment for the confounding factors including gestational age,birth weight,and neonatal critical score,the Poisson regression analysis showed that there was a significant difference in the adjusted AUR(aAUR)among the hospitals(P<0.01).The investigation results showed that among the 10 measures to reduce antibiotic use,8 measures were implemented in less than 50%of these hospitals,and the number of intervention measures implemented was negatively correlated with aAUR(r_(s)=-0.564,P=0.029).Conclusions There is a high AUR among the very low birth weight/extremely low birth weight infants in the 15 hospitals of Jiangsu Province,with a significant difference among hospitals.The hospitals implementing a relatively few measures to reduce antibiotic use tend to have a high AUR.It is expected to reduce AUR in very low birth weight/extremely low birth weight infants by promoting the quality improvement of antibiotic use management in the NICU.

关 键 词：抗生素 多中心研究 极低出生体重儿 超低出生体重儿 

分 类 号：R978.1[医药卫生—药品]