目的 探索抗菌药物科学化管理(AMS)策略,提高医院抗菌药物临床应用合理率和疑难复杂感染的诊疗水平.方法 依据抗菌药物相关法律法规,发挥职能管理部门和技术支撑体系的作用,并依托多学科会诊模式(MDT)提高AMS水平.结果 医院目前各项管理指标均达到法规要求;微生物送检率、无菌标本比例指标等远超法规要求;糖肽类、碳青霉烯类的耐药率逐年下降;治疗用抗菌药物、特殊使用级抗菌药物及耐药菌检出病例抗菌药物临床应用合理率均在98.00%以上.结论 MDT能弥补学科不足,有效提高疑难危重感染的诊疗水平,可依托其开展AMS,实现抗菌药物科学化、规范化、精细化、常态化管理.%Objective To investigate the strategy of antimicrobial stewardship(AMS),and in order to improve the rationality of drug use and the diagnosis and treatment level of difficult and complicated infection. Methods The level of AMS was improved by using the laws and regulations of antimicrobial agents,and the effect of functional and administrative department and the mode of the multidisci-plinary team (MDT). Results All kinds of management indexes in our hospital met the requirement of laws and regulations. Some in-dexes such as the microbe inspection rate and the ratio of sterile specimen had exceeded the requirement. The drug resistance rate of glycopeptides and carbapenems declined year by year. The rates of clinical rationality of antibiotics for therapeutic,special use and drug-resistant bacteria were all over 98. 00%. Conclusion MDT can make up for the shortage of discipline and effectively improve the level of diagnosis and treatment of difficult and critical infections,AMS can be used to achieve scientific,standardized,fine,standard-ized management of antibacterial drugs.
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