中国抗菌药物使用集中度和相似度分析  

Analysis of concentration and similarity of antimicrobial agent use in China

作　　者：余俊璇 杨瑶瑶 张琬朦 杜可欣 胡琳 柯唯心 黄先琴 郑波[2] 管晓东[1,3] 海沙尔江·吾守尔 史录文[1,3] YU Jun-xuan;YANG Yao-yao;ZHANG Wan-meng;DU Ke-xin;HU Lin;Weihsin Ko;HUANG Xian-qin;ZHENG Bo;GUAN Xiao-dong;Haishaerjiang·Wushouer;SHI Lu-wen(School of Pharmaceutical Sciences,Peking University,Beijing 100191,China;Institute of Clinical Pharmacology,Peking University First Hospital,Beijing 100034,China;International Research Center for Medicinal Administration,Peking University,Beijing 100191,China)

机构地区：[1]北京大学药学院,北京100191 [2]北京大学第一医院临床药理研究所,北京100034 [3]北京大学医药管理国际研究中心,北京100191

出　　处：《中国新药杂志》2024年第14期1496-1503,共8页Chinese Journal of New Drugs

基　　金：国家自然科学基金面上资助项目(81973294)。

摘　　要：目的:探究不同维度下中国抗菌药物使用集中度及相似度,为中国优化抗菌药物品种数管理提供建议。方法:利用线性回归分析对中国抗菌药物使用集中度指数变化进行统计分析;利用单因素方差分析对不同地域、省份和医院级别抗菌药物使用相似度指数的差异,不同地域和医院级别抗菌药物使用品种相似度指数的差异。结果:2015—2021年,抗菌药物使用集中度指数总体从319.8增加到377.7(P<0.05);地域之间三级医院抗菌药物使用品种相似度指数中位数为0.821,二级医院为0.716;各地域三级医院使用量占前90%的抗菌药物品种并集数量平均为61种,二级医院为52种;东部、中部、西部和东北部均在使用的品种使用量占比较高。结论:中国抗菌药物使用呈现集中趋势,地域间使用品种相似度较高,需警惕细菌耐药问题。Objective:To explore the concentration and similarity of antimicrobial agent use across various dimensions in China and offer recommendations for the optimization of antimicrobial agent management.Methods:Linear regression analysis was employed to assess the trend in the concentration of antimicrobial agent use in China.Additionally,one-way analysis of variance was utilized to examine the differences in the Herfindahl-Hirschman index(HHI)of antimicrobial agent use across different regions,provinces,and hospital levels,as well as the Jaccard index of antimicrobial agent varieties across different regions and hospital levels.Results:There was a significant increase in the overall HHI of antimicrobial agent use from 2015 to 2021,rising from 319.8 to 377.7(P<0.05).The median Jaccard index of antimicrobial agent varieties among different regions was 0.821 for tertiary hospitals and 0.716 for secondary hospitals.Furthermore,the average number of combinations of antimicrobial agents accounting for 90%of the total use in each region was 61 for tertiary hospitals and 52 for secondary hospitals.The study also found that the varieties used in the eastern,central,western,and northeastern regions accounted for a high rate of use.Conclusion:The use of antimicrobial agents in China demonstrates a trend of increasing concentration with a notable degree of similarity in the varieties used across different geographical areas.This trend raises concerns about the potential for bacterial resistance.The study underscores the need for cautious and judicious use of antimicrobial agents and suggests that there is room for improvement in the management of antimicrobial agent varieties in China to mitigate the risk of resistance development.

关 键 词：抗菌药物 品种数限制 集中度 相似度 

分 类 号：R95[医药卫生—药学]