135例住院患者抗菌药物合理应用评价.doc

135例住院患者抗菌药物合理应用评价[摘要] 目的：了解某三甲医院抗菌药物应用的合理性及医院抗菌药物分级管理制度的落实情况。方法：按事先设计好的调查表，随机抽查全院32个病区中正在使用抗菌药物的患者，填写调查表。结果：抽查的135份调查表中，抗菌药物使用指征总符合率为89.9%；药物选择合适的104例；用法、用量合适的107例；用药途径不合适的仅1例；用药疗程合理的91例；联合用药合理的40例。结论：仍须加强抗菌药物使用原则的学习，尤其是术前术后抗菌药物预防使用的学习，以及加强医院抗菌药物分级管理制度的落实。 [关键词] 抗菌药物；合理用药；调查分析 [中图分类号]R978.1 [文献标识码] B[文章编号] 1673-7210（2009）03（c）-127-02 Evaluation of antibacterial rational use in 135 cases AN Jihong1,2, WANG Zhuo1 (1.Department of Pharmacy, Changhai Hospital, Second Military Medical University, Shanghai200433, China; 2.Department of Pharmacy, Huaihe Hospital, Henan University, Kaifeng 475001, China) [Abstract] Objective:To investigate the rationality of antibacterial use in a three-grade hospital and the current situation of carrying out the antibacterial supervising system at different levels. Methods:According to the designed table, patients of 32 endemic area using antibacterial drugs were sampled randomly and then finished the designed tables. Results:In the 135 tables, the total coincidence rate of antibacterial applying indication was 89.9%, antibacterial selection in 104 cases was suitable, usage and dosage in 107 cases was suitable, only one case had a unsuitable administration route. The course of antibacterial treatment in 91 cases was rational and antibacterial combination use in 40 cases was rational. Conclusion:We still need to strengthen the study of antibacterial application guidance, especially the learning of preventive antibacterial administration principle before or after the operation, and implement the antibacterial supervising system in hospital. [Key words] Antibacterial; Rational drug use; Analysis 随着科学技术的进步，新的抗菌药物不断面市，许多过去无法医治的感染如今都能得以控制，挽救了无数患者的生命。然而，在治愈疾病的同时，由于临床广泛、不合理地使用甚至滥用抗菌药物，使得耐药菌迅速产生[1]，速度甚至超过新药的研发，导致临床上出现某些感染无药可选，严重危及患者的生命健康。1988～1998年国内医学期刊所报道的1 230例抗生素不良反应，占同期药品不良反应的46.19%[2]。因此，为保护广大人民群众用药的安全、合理，规范临床抗菌药物的使用，三部委于2004年联合制定、颁布了《抗菌药物临床应用指导原则》。在规范颁布之后，每个医院都按要求制订了本院抗菌药物的使用原则及分级管理办法。为了解医院抗菌药物的使用原则、分级管理的落实情况以及合理用药程度