我国临床抗菌药物合理应用现状与思考_肖永红.pdf

中国执业药师 合理用药 · 我国临床抗菌药物合理应用现状与思考 肖永红 （浙江大学医学院附属第一医院传染病诊治国家重点实验室，浙江杭州 310003） 【摘 要 】 我国临床目前仍存在较为严重的不合理抗菌药物应用现象，包括无指针用药、过长时间用药、过 大剂量用药和不恰当联合用药，其主要原因包括医疗卫生体制和技术性原因，如“以药养医”、临床医务人 员抗菌药物知识缺乏等；我国卫生行政管理部门已经就抗菌药物应用建立了系统的管理体系和部分技术 支撑，如“抗菌药物临床应用指导原则”、“细菌耐药监测网”和“抗菌药物临床应用监测网”等，为抗菌药物 合理应用提供了必要的保障。为了进一步规范??菌药物临床应用，需要深化医疗卫生体制改革，消除药物 使用与医疗机构的经济利益关系，建立更加完善的技术体系，开展医务人员和公众抗菌药物合理应用教育。 【关 键 词 】 抗菌药物；细菌耐药监测网；技术体系 The Current Status of Clinical Application of Antimicrobial Agents in China and Consideration on the Rational Drug Use Xiao Yonghong（State Key Laboratory for Diagnosis & Treatment of Infectious Diseases，the First Affiliated Hospital to College of Medicine of Zhejiang University，Zhejiang Hangzhou 310003，China） ABSTRACT Irrationality of clinical use of antimicrobial agents still exists in China，for example application without indication，overlong duration，overdosing or inappropriate combination of drugs，etc. The irrational drug use mostly resulted from imperfection of healthcare systemic or technical reasons，such as the way of drugs compensating healthcare service，medical staff being lack of antimicrobial knowledge. Regulations and back-up technology related to the use of antimicrobial agents have been issued by the health administrative authority，including the Technical Guideline for Clinical Application of Antimicrobial Agents，and surveillance networks for antibacterial resistance and for consumption of antimicrobial agent respectively. For further promoting the rational use of antimicrobial agents，it is necessary to deepen healthcare system reform，cut down the economic connection between the antimicrobial agent consumption and hospital compensation，set up perfect technica