目的：为临床合理使用抗菌药物提供参考。方法：从我院2012－2014 年所有出院病历中，每月随机抽取17 个临床科室各

5 份出院患者病历进行医嘱点评，2012、2013、2014 年各抽取病历1 005、1 020、1 020 份，共计3 045 份。分析抗菌药物使用的合理

性，对不合理用药问题进行归纳。结果：2012－2014 年抗菌药物使用率分别为39.90％、36.27％、32.84％，抗菌药物医嘱合理率分

别为40.90％、68.11％、82.67％。不合理用药主要表现为用药时机不合理、药物选择不合理、适应证不适宜、遴选的药品不适宜、用

法用量不适宜、联合用药不适宜、超说明书用药等。结论：通过临床药师的“事前干预”和医院行政部门的“行政干预”，我院病区抗

菌药物的使用趋于合理，但仍需加强意识与管理，有效保障患者的用药安全。

OBJECTIVE：To provide reference for rational use of antibiotics in the clinic. METHODS：From 2012 to 2014，5

medical records were selected randomly from 17 clinical departments each month，1 005 cases in 2012，1 020 cases each year in

2013 and 2014，a total of 3 045 cases. Rationality of antibiotics use was analyzed to summarize and analyze irrational drug use. RESULTS：

The rate of antibiotics use from 2012 to 2014 were 39.90％，36.27％ and 32.84％；the rational rate of antibiotics medical

orders were 40.90％，68.11％ and 82.67％. Irrational drug use manifested as irrational medication time，unreasonable drug selection，

inappropriate indications，inappropriate drug selection，inappropriate usage and dosage，inappropriate drug combination，

off-label use etc. CONCLUSIONS：By clinical pharmacists“advance intervention”and“administrative intervention”，the use of antibiotics

in wards of our hospital tend to be more reasonable. But it still necds to strengthen awareness arnd management to effectively

protect the rational drug use.