CAJ | 학술논문

目的：了解某三甲医院抗菌药物临床应用专项整治活动前后抗菌药物使用情况。方法抽取四川省某三甲医院2011年1月—2013年12月的抗菌药物使用数据，对抗菌药物品种、门急诊抗菌药物处方比例、住院患者抗菌药物使用费用占总费用比、抗菌药物使用率和使用强度、特殊使用级抗菌药物使用率和使用强度、接受限制和特殊使用级抗菌药物患者微生物送检率等数据进行回顾性分析。结果抗菌药物临床应用整治活动前，医院抗菌药物品种有88种，整治后一直保持在50种。整治活动后门急诊抗菌药物处方比和住院抗菌药物费用占总费用比均小于整治活动前（均 P ＜0．05）。整治前后抗菌药物使用率、特殊使用级抗菌药物使用率比较，差异均有统计学意义（均 P ＜0．05）。整治后接受限制和特殊使用级抗菌药物患者的微生物送检率也显著高于整治前（均 P ＜0．05）。整治后医院Ⅰ类切口手术围手术期抗菌药物预防用药率低于整治前，而术前30 min～2 h 用药比例高于整治前（均 P ＜0．05）。结论3年专项整治使医院抗菌药物的使用更趋合理，但仍需进一步加强管理，促进抗菌药物合理应用工作持续改进。
목적：료해모삼갑의원항균약물림상응용전항정치활동전후항균약물사용정황。방법추취사천성모삼갑의원2011년1월—2013년12월적항균약물사용수거，대항균약물품충、문급진항균약물처방비례、주원환자항균약물사용비용점총비용비、항균약물사용솔화사용강도、특수사용급항균약물사용솔화사용강도、접수한제화특수사용급항균약물환자미생물송검솔등수거진행회고성분석。결과항균약물림상응용정치활동전，의원항균약물품충유88충，정치후일직보지재50충。정치활동후문급진항균약물처방비화주원항균약물비용점총비용비균소우정치활동전（균 P ＜0．05）。정치전후항균약물사용솔、특수사용급항균약물사용솔비교，차이균유통계학의의（균 P ＜0．05）。정치후접수한제화특수사용급항균약물환자적미생물송검솔야현저고우정치전（균 P ＜0．05）。정치후의원Ⅰ류절구수술위수술기항균약물예방용약솔저우정치전，이술전30 min～2 h 용약비례고우정치전（균 P ＜0．05）。결론3년전항정치사의원항균약물적사용경추합리，단잉수진일보가강관리，촉진항균약물합리응용공작지속개진。
Objective To investigate the application of antimicrobial agents in a tertiary first-class hospital before and after implementing special rectification activity on clinical antimicrobial use.Methods Data about antimicrobial use in a hospital in Sichuan Province between January 2011 and December 2013 were collected and analyzed retro-spectively,data included antimicrobial varieties,the ratio of antimicrobial prescription in outpatient department to emergency department,percentage of antimicrobial application expense in the total hospitalization expense,antimi-crobial use rate and use density,antimicrobial use rate and use density of special use antimicrobial agents,microbial detection for patients receiving restricted and special antimicrobials.Results Before implementing rectification of an-timicrobial use,there were 88 kinds of antimicrobial agents in hospital,after implementing rectification,there were 50 kinds of antimicrobial agents.The ratio of antimicrobial prescription in outpatient department to emergency de-partment,and the percentage of antimicrobial expense in the total hospitalization expense were both lower than be-fore rectification (both P <0.05 ).Antimicrobial use rate and antimicrobial use rate of special use antimicrobial agents before and after rectification were all statistically different(all P <0.05).Compared with before rectification, microbial detection rate of specimens from patients receiving restricted and special use antimicrobial agents improved significantly (both P <0.05 ).Perioperative antimicrobial prophylactic use rate in patients with class Ⅰincisional operation after rectification was lower than before rectification,while percentage of antimicrobials used 30 min-2 h before operation was higher than before rectification (both P <0.05).Conclusion After three year special rectifica- <br> tion,antimicrobial use become more rational,but management still needs further and continuous improvement.