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目的:了解专项整治前后某三甲医院住院患者抗菌药使用情况及医院感染率的变化,为抗菌药的管理提供依据。方法:调取某三甲医院2010年7~12月(整治前)和2012年7~12月(整治后)住院患者抗菌药使用数据,并进行统计分析。结果:该院专项整治前后抗菌药8项指标发生明显变化:住院患者抗菌药使用率分别为75.84%和54.46%、使用强度(AUD)分别为82.63和52.77 DDD/100人天、特殊使用类抗菌药使用量占抗菌药总使用量比例分别为21.33%和12.73%、Ⅰ类切口手术预防用抗菌药比例分别为100%和45%、介入诊疗手术预防用抗菌药比例分别为100%和0%、治疗用药微生物检验样本送检率分别为38%和43%、住院患者人均使用抗菌药费用分别为1 455元和812元、抗菌药费用占药物总费用比例分别为28.98%和14.38%,手术科室的变化尤为明显,医院感染率有所降低。结论:某三甲医院通过实施抗菌药物专项整治和双重干预措施,各项抗菌药应用指标发生明显改善,且多项指标已符合卫生部规定,专项整治的效果比较明显。重症医学室(ICU)的抗菌药使用方面仍然需要提出更具效果的措施,加强监管。
Objective: To understand the use of antimicrobials in hospitalized patients in a top three hospital before and after the special rectification and the change of nosocomial infection rate, so as to provide the basis for the management of antimicrobial agents. Methods: The data of antimicrobial use in hospitalized patients from July 2010 to July 2010 (before remediation) and from July to December 2012 (after remission) were retrieved and statistically analyzed. Results: Eight indicators of antibacterials changed significantly before and after the special treatment: the inpatient antibacterials utilization rates were 75.84% and 54.46% respectively, and the intensity of use was 82.63 and 52.77 DDD / 100 days, respectively. The proportion of the use of antibiotics in the total amount of antibacterial drugs were 21.33% and 12.73% respectively. The proportion of antimicrobial agents used for class I incision surgery was 100% and 45% respectively. The proportion of antibacterial agents used in the prevention and treatment of interventional surgery was 100% and 0% , The rate of drug use for the treatment drug microbiology sample was 38% and 43% respectively, and the average cost of antimicrobial drug was 1 455 yuan and 812 yuan respectively for inpatients and 28.98% and 14.38% respectively for antimicrobial drug, Department of changes is particularly evident, the hospital infection rate decreased. Conclusion: The implementation of special antimicrobial agents and double interventions in some top three hospitals have significantly improved the application of various antimicrobial agents, and many indicators have met the requirements of the Ministry of Health. The effect of special rectification is obvious. The use of antimicrobials in the ICU still requires more effective measures to strengthen regulation.