基于降低抗菌药物使用强度的药学服务实践  

Practice of Pharmaceutical Care Based on Reducing the Antibiotics Use Density

作　　者：孙嘉婧[1] 王洪贵[1] 李小梅[1] 曾勇[1] SUN Jiajing;WANG Honggui;LI Xiaomei;ZENG Yong(Dujiangyan People′s Hospital,Chengdu,Sichuan,China 611830)

机构地区：[1]四川省都江堰市人民医院,四川成都611830

出　　处：《中国药业》2025年第5期120-123,共4页China Pharmaceuticals

基　　金：中国药学会科技开发中心科普项目[CMEI2022KPYJ00106,CMEI2022KPYJ00206]。

摘　　要：目的 探讨以降低抗菌药物使用强度为目的的药学服务在降低住院患者抗菌药物使用强度(AUD)中的成效。方法 临床药师分析各科室AUD高的原因,以科室AUD≤60%年初目标值为目标,结合患者感染部位、感染症状、检验指标、影像学及科室具体情况提出干预措施,比较干预前(2023年4月至9月)、干预后(2023年10月至12月)各科室抗菌药物使用相关指标,分析基于降低AUD为目的的药学服务路径的干预效果。结果 该院2023年的AUD由36.85用药频度(DDDs)降至30.06 DDDs;全年AUD为34.52 DDDs,经病例组合指数(CMI)值(0.89)校正后为38.79 DDDs,达到三级综合医院住院患者AUD不超过40 DDDs的标准。全院住院患者的抗菌药物使用率由50.79%降至44.85%,人均抗菌药物总费用由659.56元下降至581.37元。结论 基于降低AUD的药学服务路径行之有效,能促进医院抗菌药物的合理使用。Objective To investigate the effectiveness of pharmaceutical care based on reducing the antibiotics use density(AUD)in inpatients.Methods Clinical pharmacists analyzed the reasons for high AUD in each department.With the goal of achieving the target value of AUD≤60%at the beginning of the year,intervention measures were put forward based on the patient's infection site,infection symptoms,test indicators,imaging,and the specific situation of the department.The relevant indicators of antibiotic use in each department were compared before the intervention(from April to September 2023)and after the intervention(from October to December 2023)were compared,and the intervention effect of the pharmaceutical care pathway based on reducing AUD was analyzed.Results The AUD of the hospital in 2023 decreased from 36.85 DDDs to 30.06 DDDs.The annual AUD was 34.52 DDDs,and after adjusting for the case mix index(CMI)value(0.89),the AUD was 38.79 DDDs,which met the standard of AUD≤40 DDDs for inpatients in the tertiary comprehensive hospital.The usage rate of antibiotics among inpatients in the hospital decreased from 50.79%to 44.85%,and the total cost of antibiotics per capita decreased from CNY 659.56 to CNY 581.37.Conclusion The pharmaceutical care pathway based on reducing AUD is effective,which can promote the rational use of antibiotics in the hospital.

关 键 词：临床药师 抗菌药物使用强度 药学服务 合理用药 实践效果 

分 类 号：R95[医药卫生—药学] R978.1