目的：为单机构和跨机构抗菌药物的安全应用提供参考。方法：参考文献构建抗菌药物用药安全评价指标体系，采用病历追踪法获取医联体模式下下呼吸道感染性疾病儿童的病历资料，并进行病历配对和专家评判，对单机构抗菌药物用药安全和跨机构抗菌药物用药安全衔接情况进行分析。结果：共获得有效配对病历248例。医联体大医院抗菌药物联合使用率为86.29％，高于社区医疗机构的77.02％（χ2＝5.49，P＜0.05）；大医院儿童抗菌药物使用错误率为14.52％，低于社区医疗机构的25.81％（χ2＝9.733，P＜0.05）；转诊住院儿童在前后医疗机构间的抗菌药物用药矛盾较多，各类抗菌药物风险用药情况共发生128例，总体发生率为51.61％。结论：医联体模式下单机构住院儿童抗菌药物用药安全堪忧，转诊住院儿童抗菌药物用药衔接安全性低。%OBJECTIVE:To provide reference for safe application of antibiotic drugs in single or inter-medical institution ser-vices. METHODS:An antibiotic drug safety evaluation index system was established by reference to literatures. Medical records tracing method was adopted to obtain the medical records of children with respiratory infectious diseases under the medical consor-tium model. The medical records were matched and evaluated by experts to analysis the safety of antibiotic drug use in single medi-cal institution and the connection between two medical institutions with respect to the safety of antibiotic drug use. RESULTS:248 effective medical records had been obtained. Under the medical consortium model,the rate of the combination of antibiotic drugs in large hospitals was 86.29%,higher than the community hospitals of 77.02%(χ2=5.49,P<0.05). The error rate of antibiotic drug use by children in large hospitals was 14.52%,lower than the community hospitals of 25.81%(χ2=9.733,P<0.05). There were many contradictions in antibiotic drug use between the medical institution where children received treatment initially and the medi-cal institution which the children were referred to and hospitalized in. There were totally 128 cases of unsafe antibiotic drug use, with the overall incidence of 51.61%. CONCLUSIONS:Under the medical consortium model,the safety of antibiotic drug use by the hospitalized children in single medical institution is worrying,and the connection between two medical institutions with respect to the safety of antibiotic drug use by children who are referred and hospitalized is less reliable.
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