2016-2020年浙江省某县12家基层医院门诊头孢类抗菌药物使用情况分析  

Cephalosporin prescriptions for outpatients in 12,primary medical institutions in a county of Zhejiang province,2016-2020:an analysis on outpatient prescription records

作　　者：韩世宇 董晓莲[2] 王莹莹 陈颖峰[2] 王娜 严非 付朝伟 HAN Shiyu;DONG Xiaolian;WANG Yingying;CHEN Yingfeng;WANG Na;YAN Fei;FU Chaowei(Department of Epidemiology,School of Public Health,Fudan University,Key Lab of Health Technology Assessment of National Health Commission,Fudan University,Shanghai 200032,China;Deqing County Center for Disease Control and Prevention,Huzhou 313200,China)

机构地区：[1]复旦大学公共卫生学院流行病学教研室、国家卫生健康委员会卫生技术评估重点实验室(复旦大学),上海200032 [2]德清县疾病预防控制中心,湖州313200

出　　处：《中国公共卫生》2024年第3期362-366,共5页Chinese Journal of Public Health

基　　金：国家自然科学基金(81861138050);德清县科学技术局资助项目(2020SK15)。

摘　　要：目的 了解浙江省某县基层医院2016-2020年门诊患者头孢菌素类抗菌药物使用情况,为进一步规范基层医院头孢类药物临床应用提供参考依据。方法 通过医疗机构数据共享平台抽取2016-2020年12家基层医院门诊处方记录,描述各年度头孢类用药情况,利用线性回归分析判断头孢类用药的变化趋势,采用χ^(2)检验分析2016-2020头孢类药物处方结构在年龄、性别、用药原因和给药途径方面的变化。结果 2016-2020年,该县12家基层医院年均开具门诊处方163 527张,抗菌药物处方30 459张,抗菌药物年均使用率为19.03%。头孢菌素类抗菌药物使用率(β=-1.09,P <0.001)和用药频度占比(β=-4.81,P=0.012)均呈明显下降趋势。该县门诊头孢菌素类抗菌药物的用药频度呈现冬季高、夏季低的季节性变化。在头孢菌素类构成中,第1代头孢菌素类呈迅速下降趋势(β=-11 965.35,P=0.047),第2代头孢菌素类呈现上升趋势(β=4 041.92,P=0.003)并占据主要地位。其间,头孢呋辛酯和头孢克洛的用药频度稳居前3位。处方构成中,用药原因以呼吸系统疾病为主;≥60岁老年患者和口服给药比例均逐渐上升。结论 该县基层医院门诊头孢菌素类抗菌药物使用基本合理。Objective To investigate cephalosporin prescriptions in outpatient settings within primary medical institutions in a county of Zhejiang province from 2016 to 2020 for standardizing the clinical application of cephalosporins.Methods The outpatient prescription records of 4 community health service centers and 8 township health centers in the county from 2016 to 2020 were obtained through the data sharing platform of medical institutions.The cephalosporin prescriptions for each year were documented,and the trends in cephalosporin prescription patterns were analyzed using linear regression analysis.Changes in the age,gender,reasons for medication,and route of administration associated with cephalosporin prescriptions during the 5-year period were examined using a chi-square test.Results During the period,a total of 163527 outpatient prescriptions were issued by the 12 medical institutions,with 30459 of them being for antibiotics.The mean annual proportion of antibiotic prescriptions was 19.03%.The annual proportion of antibiotic prescriptions showed a significant downward trend(β=-1.09,P<0.001),as well as the cephalosporin prescriptions(β=-4.81,P=0.012)during the period.The proportion of cephalosporin prescriptions for outpatients exhibited a seasonal variation,with a higher proportion observed during the winter season and a lower one during the summer season.In terms of the Anatomical Therapeutic Chemical classification,there was a significant decline in the prescription rates of first-generation cephalosporins(β=-11,965.35,P=0.047),while second-generation cephalosporins exhibited an upward trend(β=4,041.92,P=0.003)and emerged as the dominant choice for prescribing,with cefuroxime and cefaclor being among the most frequently prescribed second-generation cephalosporins.The majority of cephalosporin prescriptions were allocated for the treatment of respiratory infections,while there was a gradual increase in outpatient prescriptions for oral administration of cephalosporins and individuals aged 60 years and above

关 键 词：头孢菌素类 抗菌药物 基层医院 门诊患者 用药频度 

分 类 号：R969[医药卫生—药理学]