社区卫生服务中心门诊抗菌药处方剖析.docVIP

社区卫生服务中心门诊抗菌药处方剖析 　　摘 要 目的：分析社区全科门诊抗菌药物不合理应用的现象及原因，探讨改进措施，以促进抗菌药物的合理使用。方法：随机抽取我中心2011年7月~2012年1月全科门诊的抗菌药处方3120张，统计不合理处方数和不合理应用的类型，加以分析并提出改进措施。结果：在抽取的抗菌药处方中发现不合理处方为136张，占4.36%，其中“诊断与用药不符”和“用法用量不适宜”所占比例较高，分别占39.71%和36.03%。结论：我中心门诊抗菌药处方属不合理应用的比例仍较高，其原因主要是单纯病毒感染使用抗菌药物。 　　关键词 全科门诊 抗菌药 不合理应用 分析 　　中图分类号：R541.6+1 文献标识码：A 文章编号：1006-1533（2012）06-0027-03 　　The analysis of the improper usage of antibiotics at the out-patient clinics of the community heath service center 　　WANG Jia-ying，WANG Hui，WANG Zhi-liang，ZHANG Yuan，SHENG Guo-hua 　　（Xuijiahui Community Healthcare Service Center, Shanghai 200030） 　　ABSTRCT Objective: To demonstrate the phenomena and reasons of the improper usage of antibiotics at the general practitioner out-patient clinics of the community health service centre and explore the measures to improve the proper usage of antibiotics. Method: Randomly 3 120 antibiotics prescriptions at the general practitioner out-patient clinics were chosen from Jul. 2011 to Jan. 2012 in our community health service center and the amount of the improper prescriptions and items were summarized so as to analyze and find out the improvement measures. Result: 136 improper prescriptions from the overall antibiotics prescriptions were found, which accounted for 4.36%. From the improper ones, the dominant reasons were “inconsistency of diagnosis and medication “ and “improper usage and dosage” , which took 39.71% and 36.03% respectively. Conclusion: Based on the analysis of the reasons of improper antibiotic usage, we found it was caused by both doctors and patients. We need to explore the improvement measures to prevent the abuse of antibiotics based on the characteristics of the community general practitioner. 　　KEY WORDS general practitioner out-patient clinics； antibiotic; improper usage； analysis 　　抗菌药物在临床上应用广泛，而我国不合理应用抗菌药的现象则较为突出，对抗菌药的不合理应用不仅浪费了卫生资源，加重了医药费用的负担，且由此造成的细菌耐药问题尤为突出，某些临床分离菌对药物的耐药严重程度已居世界首位[1]。社区全科门诊中随意应用抗菌药的现象很普遍，为全面深入的了解使用抗菌药物的现状，也为了促进合理用药，随机抽取了我中心所有全科门诊2011