CAJ | 학술논문

目的：近年来抗菌药的不合理使用导致了药物不良反应增加、社会医疗负担加重等问题。文中通过南京军区南京总医院住院患者抗菌药物使用情况的调查分析，了解抗菌药物专项整治活动效果。方法选取整治前患者病案132份，整治后167份，分别对治疗用药微生物送检率、抗菌药物应用指标及Ⅰ、Ⅱ类切口手术用药情况，进行对照研究。结果整治后各级别治疗用药微生物送检率较整治前明显增加，尤以特殊级药物送检率增加显著（81．9％vs 32．1％， P＝0．016）；抗菌药物使用率、使用强度、人均抗菌药物费用及抗菌药物占药费比例明显下降；Ⅰ类切口手术无指征预防用药率及给药时间明显减少[43．7％vs 100．0％，（1．85±1．72）d vs （3．19±1．74）d， P＜0．01]，Ⅰ、Ⅱ类切口手术预防用药品种选择、用法用量、给药时机及更换药物的不合理率显著降低（ P＜0．05）。结论医院整治措施有效、可行，抗菌药物临床应用日趋规范。
목적：근년래항균약적불합리사용도치료약물불량반응증가、사회의료부담가중등문제。문중통과남경군구남경총의원주원환자항균약물사용정황적조사분석，료해항균약물전항정치활동효과。방법선취정치전환자병안132빈，정치후167빈，분별대치료용약미생물송검솔、항균약물응용지표급Ⅰ、Ⅱ류절구수술용약정황，진행대조연구。결과정치후각급별치료용약미생물송검솔교정치전명현증가，우이특수급약물송검솔증가현저（81．9％vs 32．1％， P＝0．016）；항균약물사용솔、사용강도、인균항균약물비용급항균약물점약비비례명현하강；Ⅰ류절구수술무지정예방용약솔급급약시간명현감소[43．7％vs 100．0％，（1．85±1．72）d vs （3．19±1．74）d， P＜0．01]，Ⅰ、Ⅱ류절구수술예방용약품충선택、용법용량、급약시궤급경환약물적불합리솔현저강저（ P＜0．05）。결론의원정치조시유효、가행，항균약물림상응용일추규범。
Objective The article was to promote the rational use of antibiotics by comparative analysis on antimicrobial us -age before and after the special rectification on clinical application of antibacterial drugs in our hospital . Methods Medical record data of 132 inpatients before the rectification and 167 inpatients after the rectification were randomly collected for the rational compara-tive analysis on microorganism submission rate for treatment , usage of antibiotics and medication for typeⅠandⅡincisions . Results The microorganism submission rate was much higher , especially the special grade antibiotics (81.5 %vs 32.1%).There was also a remarkable decrease in the percentage of antibiotics use , the strength of utilization and the average drug cost .The amount of antibiotic prophylaxis without indication and the length of medication for typeⅠincisions showed a remarkable decrease (P<0.05).Remarkable decrease was also observed in the irrational usage rate of antibiotic prophylaxis , dosage, medication time and drug replacement for typeⅠand Ⅱincisions (P<0.05). Conclusion The special rectification measures are effective and practical , which can promote the rational use of antibiotics .