特殊使用级抗菌药物网络在线审批对抗菌药物使用指标及细菌耐药的影响
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篇名: 特殊使用级抗菌药物网络在线审批对抗菌药物使用指标及细菌耐药的影响
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摘要: 目的:为特殊使用级抗菌药物的合理使用提供参考。方法:回顾性分析我院2012-2014年特殊使用级抗菌药物网络在线审批实施前后抗菌药物使用率、用量、销售金额、使用强度、微生物标本的送检率及主要致病菌的耐药率等。结果:2012-2014年,我院住院患者抗菌药物使用率由56.17%下降至53.62%,住院患者抗菌药物使用强度由66.50 DDDs/(100人·d)下降至55.53 DDDs/(100人·d)。特殊使用级抗菌药物用量占比由12.27%下降至6.72%,特殊使用级抗菌药物使用强度由8.16 DDDs/(100人·d)下降至3.73 DDDs/(100人·d),特殊使用级抗菌药物治疗前微生物送检率由79.65%上升至91.41%。主要病原菌为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌和金黄色葡萄球菌,其构成比例3年间无显著变化;除大肠埃希菌产酶率上升8%外,其他致病菌耐药率处于稳定及下降趋势。结论:我院特殊使用级抗菌药物网络在线审批流程规范、简便、高效;实施后抗菌药物的使用指标有明显改善;虽对主要致病菌的构成没有显著影响,但能使耐药率控制在稳定的局面。
ABSTRACT: OBJECTIVE: To provide reference for rational use of autibacterial drugs for special use. METHODS: A retrospective analysis was performed of online approval of antibacterial drugs for special use in our hospital. The dates during 2012-2014 period was analyzed on indicators, including the utilization ratio of antibacterial drugs, consumption amount, AUD, submission rate of microbial specimen, resistance rate of major pathogenic bacteria. RESULTS: During 2012-2014, the utilization ratio of antibacterial agents of our hospital for inpatients decreased from 56.17% to 53.62%, and AUD decreased from 66.50 DDDs/(100 person·d)to 55.53 DDDs/(100 person·d). The proportion of antibacterial drugs for special use decreased from 12.27% to 6.72%, and AUD decreased from 8.16 DDDs/(100 person·d)to 3.73 DDDs/(100 person·d); submission rate of microbial specimen increased from 79.65% to 91.41%. The main pathogenic bacteria were Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, Acinetobacter baumannii and Staphylococcus aureus, and their constituent ratio had no significant change; enzyme-producing rate of E. coli increased by 8%, while resistance rate of other bacterials kept stable or decreased. CONCLUSIONS: The approval procedure of antibacterial drugs for special use is standard, convenient and effective, and it significantly improves the indicators of antibacterial use; however, it dosen’t influence the constituent of main pathogens and control resistance rate.
期刊: 2016年第27卷第14期
作者: 方维军,张艳丽,袁曼,高婕
AUTHORS: FANG Weijun,ZHANG Yanli,YUAN Man,GAO Jie
关键字: 特殊使用级抗菌药物;销售金额;使用强度;耐药率;网络审批
KEYWORDS: Antibacterial drugs for special use; Consumption sum; AUD; Resistance rate; Network audit
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