利用医院信息体系实施抗菌药物分级管理.docVIP

利用医院信息体系实施抗菌药物分级管理[摘要] 了解本院抗菌药物分级管理干预措施的实施及效果。通过医院信息系统抗菌药物分级管理子系统采集出院患者的抗菌药物使用信息,对这些信息进行回顾性分析。本院抗菌药物管理制度严格,分级管理合理,效果显著。抗菌药物使用率得到较好控制,一线药物使用频数较高,但第三代头孢类抗菌药物在临床使用中所占比例仍较大。实施分级管理不仅有利于抗菌药物的合理使用,而且节省卫生资源,但管理措施仍需进一步加强和提高。 [关键词] 抗菌药物;分级管理;合理用药 [中图分类号] R978.1 [文献标识码]B [文章编号]1674-4721(2010)05(b)-120-02 Classified management of antibiotics in the system of hospital information YANG Ming (The People’s Hospital of Xixiang,Guangdong Province,Shenzhen 518102,China) [Abstract] To explore the practices and effect of the classified management of antibiotics in our hospital. Information of the patients which used antibiotics was collected from the classified management system in our hospital.Then the retrospective analysis was done with the information above. The institution of antibacterial drug management system in our hospital was strict, at the same time, the classified management was reasonable,in the final, the results was remarkable. The usage of antimicrobial drugs was under better control.However,the using frequency of the first-line drugs was higher than that of the others,the proportion of the third-generation cephalosporins antibiotics was still larger in clinic. Implementation of the classified management was not only conducive to the rational usage of antibiotics,but also benefited to save health resources.In contrast,the management measures still needed to be further strengthened and enhanced. [Key words] Antibiotics; Classified management; Rational usage 我国临床抗生素的使用的不合理现象主要表现在以下几个方面:首先,抗生素滥用及重复使用问题。临床抗生素的使用趋向由单一向联合用药转变,借以从不同的机制抗菌,加强疗效及加大抗菌范围。虽然治疗的有效性尚无确定的结论,但是同时也加大了患者的经济压力并且可使细菌同时对多种抗生素产生耐药性,也是对我国卫生资源的一种浪费。如2006年的一个统计表明,不合理使用第三代头孢类抗菌药物这一项[1],就使我国每年浪费卫生资源17亿元。其次,追求新药贵药。某些医院片面强调和追求利润,对临床医生滥用抗生素不闻不问,甚至鼓励医生开利润较高的进口药、贵重药,造成医生在处置病情时以患者的经济承受能力为用药准则。 1 抗菌药物分类 医院信息化建设水平已成为检验医院管理质量的关键之一,其中,抗菌药物分级管理系统又是直接使患者得到实惠的信息化应用。为了合理使用抗菌药物,更好地发挥抗菌药物在临床治疗中的作用,延缓细菌耐药性的产生,加大抗菌药物的管理力度及对抗菌药物实行分级管理是十分必要的。依据卫生部特别制订的《抗菌药物临床应用指导原则》[2],并结合抗菌药物特点、临床疗效、细菌药、不良反应及本地区社会经济状况、药