CAJ | 학술논문

目的通过调查分析人流后预防感染的用药情况及方案，在用药成本和抗感染效果之间找到一个最佳的平衡点。方法 2012 年8 月～ 2014 年4 月对西城区各级医院、不同职称的200 名医师进行问卷调查，就《医疗机构抗菌药物管理办法》出台前后医师对人流后使用抗生素预防感染的态度以及抗生素的品种选择、联合用药情况、用药途径及用药天数等进行调查分析，并计算患者用药方案的成本，筛选出成本和效果最佳的人流预防感染用药方案。结果《办法》出台前后在抗生素的使用率、口服途径率、静脉途径率、单独使用抗生素率以及药物选择不当、联合用药、给药时机不当、用法用量不合理、超范围用药和细菌学送检数方面的比较，差异均有统计学意义，P ＜ 0.05 ；抗生素使用的疗程明显缩短，使用强度（DDD）下降；筛选出了4 个用于人流后预防感染的安全高效、低成本的单药方案。结论人流后不使用抗生素预防感染或应用“甲硝唑”、“甲磺酸左氧氟沙星”、“阿莫西林”、“阿奇霉素”等安全高效、低成本的单药方案用于人流后感染的预防是可行的，但其对于高危病人的有效性还需要进一步的临床研究验证。
목적 통과조사분석인류후예방감염적용약정황급방안，재용약성본화항감염효과지간조도일개최가적평형점。방법 2012 년8 월～ 2014 년4 월대서성구각급의원、불동직칭적200 명의사진행문권조사，취《의료궤구항균약물관리판법》출태전후의사대인류후사용항생소예방감염적태도이급항생소적품충선택、연합용약정황、용약도경급용약천수등진행조사분석，병계산환자용약방안적성본，사선출성본화효과최가적인류예방감염용약방안。결과《판법》출태전후재항생소적사용솔、구복도경솔、정맥도경솔、단독사용항생소솔이급약물선택불당、연합용약、급약시궤불당、용법용량불합리、초범위용약화세균학송검수방면적비교，차이균유통계학의의，P ＜ 0.05 ；항생소사용적료정명현축단，사용강도（DDD）하강；사선출료4 개용우인류후예방감염적안전고효、저성본적단약방안。결론 인류후불사용항생소예방감염혹응용“갑초서”、“갑광산좌양불사성”、“아막서림”、“아기매소”등안전고효、저성본적단약방안용우인류후감염적예방시가행적，단기대우고위병인적유효성환수요진일보적림상연구험증。
ObjectiveTo Through the investigation and analysis for medication to prevent infection after artificial abortion, to find out an optimal balance point between the cost of medicine and effect of anti-infection.Methods Questionnaire surveys were conducted by 200 physicians of different professional titles in the different levels hospitals of Xicheng District from August in 2012 to April in 2014. Investigated and analysed the attitudes of physicians who used antibiotics to prevent infection after artificial abortion,and the selection of antibiotic,combined use of antibiotics ,approach and days for medicine applied etc before and after Administrative measures of medical institutions for antibacterial drugs published. And then calculate the cost of medication for patients, to find out the best cost and effect. Results Before and after measures,the difference had statistical significance in the use frequency of antibiotic,oral use rate,intravenous use rate ,individual use rate and improper selection of medicine, combined use of medicine, improper time of taking medicine, unreasonable usage and dosage, medication beyond the scope, the number of bacteriological inspection, P<0.05. The uses of antibiotic were significantly shorten, intensity of use (DDD) was decreased from 62 to 28. We screened out 4 single medicine schemes which was safe and high efficient and low cost for preventing infection after artificial abortion. Conclusion It was feasible for disusing antibiotics or using safe and high efficient and low cost single medicine schemes such as "Metronidazole",“Levofloxacin mesylate”, “Amoxicillin”, “Azithromycin” and so on to prevent infection after artificial abortion, but its reasonableness for highrisk patients still needed to test and verify.