2010年儿科支气管肺炎(住院)抗生素应用调查研究

摘要

目的 调查分析本院儿科2010年支气管肺炎(住院)患者抗生素应用情况,供儿科医师临床工作中合理使用抗生素提供参考.方法 应用回顾性调查研究方法,提取本院2010年儿科支气管肺炎住院病例341例,对抗生素使用情况进行统计和分析.从计算机数据库调取病例及相关数据,对儿科支气管肺炎住院病人抗生素用药品种及使用率、用药剂最及用药次数、对患儿不同白细胞水平抗生素使用情况进行调查统计、对病原体送检率、联合使用情况等进行统计分析.结果 儿科支气管肺炎(住院)病人抗生素使用率过高,341病例中,共328例(96.18％)应用抗生素,严重超出卫生部(＜50％)和WHO(＜ 30％)标准；口服药品使用比例低,患儿住院期间使用的抗生素均为静脉用药,口服抗生素均为出院带药；抗生素剂量及次数不合理；病原学检查不及时,仅101例(29.62％)行病原学检查,低于卫生部标准(＞30％).结论 儿科医生应加强对支气管肺炎(住院)病人抗生素用药的重视,根据病原学检查结果,安全、有效、合理选择用药品种、用药方式,正确选择抗生素剂量及次数,使疾病治疗由经验治疗转为病原治疗.%Objective To investigate and analyze the status of the antibiotics usage in bronchopneumonia of the children in-patient in pediatrics in 2010 and provide the reference for clinic.Methods By using the retrospective study method,341 cases of bronchopneumonia of the children in-patient in pediatrics in our hospital during 2010 were selected to start and analyze the usage of antibiotics.The cases and related data were taken from the computer database and statistically analyzed,the kinds of drugs,the using ratio,the dosage and times of antibiotic drugs were investigated.The patients were divided into different groups as the different severity of the disease(WBC level) and the antibiotics usage in each group was surveyed.Data of pathogeny checking ratio was combined with the drug usage and united drugs.Results The ratio of antibiotic utilization of infection inpatients was higher than normal standard.Among the 341 children,328(96.18％) were using antibiotics during the hospitalization,the ratio also outran the MOH( ＜ 50％) and WHO( ＜ 30％) criterion seriously.The doctors seldom used the oral antibiotics drugs.All of the 328 children were applied with antibiotics in the way of venous transfusion,the oral antibiotics drugs were only used when the patients left hospital.The dosage and times of antibiotic drugs were also unreasonable.The check of pathogeny wasn抰 in time.Among the 341 children,only 1 01 (29.62 ％) were applied with the check of pathogeny.The ratio of pathogeny check was lower than the MOH standard ( ＞30％).Conclusion Doctors should take the antibiotics usage into account in the children with pneumonia.The safe,effective and reasonable kinds of drug and the mode of medications should be determined by the check of pathogeny.Doctors also should choose the dosage and times of antibiotic drugs rightly,changing the empirical therapy to the pathogenic treatment.