丹阳市第二人民医院5841张门急诊抗菌药物处方分析

摘要

OBJECTIVE:To investigate the rational utilization of antibiotics in prescriptions of the Second People's Hospital of Danyang ( hereinafter referred to as “our hospital”) , so as to improve the level of rational utilization of antibiotics in clinicians.METHODS:According to the Specification of Prescription Comment ( Trial ) from Ministry of Health, 5 841 antibiotics prescriptions in outpatient and emergency department from 2012 to 2014 were evaluated and analyzed.The statistics of drugs'types, varieties and departments were respectively statistically analyzed from the top 10 utilization frequency.RESULTS: The top three utilization rate of antibiotics categories in 2013 were cephalosporins, macrolides and nitro imidazoles, and in 2014 were cephalosporins,β-lactamase compound preparation and macrolides;The top three utilization frequency of drug varieties in 2013 were cefuroxime sodium fro injection, Erythromycin enteric coated capsule and ceftizoxime sodium for injection, and in 2014 were cefoxitin sodium for injection, Cefixime dispersible tablets and amoxicillin sodium for injection.The top three departments of antibiotics prescriptions in 2013 were the department of internal medicine, pediatrics and obstetrics and gynecology, and in 2014 were department of pediatrics, internal medicine and obstetrics and gynecology.There were irrational phenomenon in the utilization of antibiotics, mainly performed as inappropriate medication selection and medication with no indications.CONCLUSIONS:Compared with 2013, the proportion of irrational prescriptions in 2014 has increased, but the proportion of inappropriate medication and supernormal prescriptions has significantly decreased.The hospital should continuously strengthen the supervision and management, so as to improve the prescription quality and level of rational drug use.%目的：了解丹阳市第二人民医院（以下简称“我院”）抗菌药物处方合理用药情况，以提高临床医师合理应用抗菌药物的水平。方法：抽取我院2013年和2014年门急诊抗菌药物处方5841张，按照卫生部《医院处方点评规范（试行）》进行评价分析。分别从使用频率排前10位抗菌药物类别、品种及科室方面统计分析，并对不合理应用抗菌药物的处方进行分类讨论。结果：抗菌药物类别使用率排前3位的2013年为头孢菌素类、大环内酯类及硝基咪唑类，2014年为头孢菌素类、β-内酰胺酶抑制剂复方制剂及大环内酯类；使用频率排前3位的品种2013年为注射用头孢呋辛钠、红霉素肠溶胶囊及注射用头孢唑肟钠，2014年为注射用头孢西丁钠、头孢克肟分散片及注射用阿莫西林／舒巴坦钠；开具抗菌药物排前3位的科室2013年为内科、儿科及妇产科，2014年为儿科、内科及妇产科。抗菌药物应用存在不合理情况，主要表现为选药不适宜、无适应证用药。结论：2014年不合理处方比例较2013年有所上升，但用药不适用处方和超常处方比例都下降较多。医院应继续加强监督管理，提高处方质量和合理用药水平。