处方点评干预前后某院住院患者抗菌药物使用的对照分析Comparative Analysis of Antibiotics Usage in Inpatients in A Hospital Before and After Prescription Comments Intervention
刘小芹,周淑英,黄荣海
LIU Xiaoqin,ZHOU Shuying,HUANG Ronghai
摘要(Abstract)：
目的通过处方点评促进临床抗菌药物合理使用。方法随机抽取2013-11~2014-03(干预前)、2014-04~08(首轮干预)、2014-09~2015-01(次轮干预)3个时间段住院病历各1 500份,临床药师按照抗菌药物专项整治要求和抗菌药物临床应用指导原则等对住院患者抗菌药物使用情况进行合理性评价。结果经过2轮处方点评干预,住院患者抗菌药物使用率从59.67%降低到44.80%,抗菌药物使用强度从72.2降为45.2,抗菌药物联用比例从6.67%降为5.67%,Ⅰ类切口手术预防性使用抗菌药物的比例从63%降为34%,平均每名住院患者抗菌药费用降低了120.73元。但无指征用药和疗程偏长现象仍较为突出。结论处方点评可有效改善住院患者抗菌药物的使用情况,但不合理用药现象仍然存在,有待进一步改进。
OBJECTIVE To promote the clinical rational application of antibacterial drugs through prescription comments.METHODS A total of 1 500 hospital medical records in a hospital during Nov. 2013-Mar. 2014( before intervention),Apr.-Aug.2014( the first round of intervention) and Sep. 2014 to Jan. 2015( the second round of intervention) were chosen randomly and to evaluate the rationality of the antibiotic application of inpatients by clinical pharmacists according to the guiding principles of " clinical application of antimicrobial drugs" and the Special Modification Plan for Use of Antibacterial Agents,etc.RESULTS After 2 round of prescription comment intervention,the rate of antibiotic use in the inpatients decreased from 59.67% to 44.80%,AUD declined from 72.2 DDDs to 45.2 DDDs,the ratio of combination use of antibiotic drugs decreased from 6.67% to 5.67%,the prophylactic utilization ratio of antibiotics in the typeⅠIncision surgery decreased from 63% to 34%,the average inpatient antimicrobial drug cost reduced 120.73 yuan. But no indications of medication and long course of treatment were still more prominent. CONCLUSION Prescription comment can effectively improve the rational application of antimicrobial drugs,but the irrational use phenomena still exist,it remain to be further improved.
关键词(KeyWords)：
抗菌药物;处方点评;干预;分析
antimicrobial agents;prescription comment;intervention;analysis
基金项目(Foundation): 中山市科技计划基金项目(2014A1FC147)
作者(Author):
刘小芹,周淑英,黄荣海
LIU Xiaoqin,ZHOU Shuying,HUANG Ronghai
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