目的 分析2014年天津中醫(yī)藥大學第一附屬醫(yī)院抗菌藥物的使用情況,為合理使用抗菌藥物提供依據(jù)。方法 總結天津中醫(yī)藥大學第一附屬醫(yī)院2014年每月門急診及住院患者的抗菌藥物處方,對抗菌藥物的用藥金額、使用科室、應用情況及不合理使用問題等進行統(tǒng)計分析。結果 2014年門急診、住院病區(qū)抗菌藥物的用藥金額分別占總用藥金額的1.8%、9.4%;抗菌藥物的使用患者較普遍,門急診主要集中于兒科、急癥科和婦科,住院病區(qū)主要集中于兒科和腫瘤科;從全院整體上看,本年度用藥金額和用藥頻度最高的均為二線抗菌藥物;使用的抗菌藥物品種多集中在頭孢類、大環(huán)內酯類、喹諾酮類及氨基糖苷類、新型三唑類等。另外,處方不合理的原因有所開藥物的適應癥與病情不符、給藥方法和劑量不當、用藥療程和藥物聯(lián)用不合理等。結論 結合門急診及住院病區(qū)抗菌藥物的使用情況,針對性地加強醫(yī)師抗菌藥物的培訓和合理使用,加強管理,建立獎罰制度,優(yōu)化篩選抗菌藥物的品種,以找出更好更充分的利用藥物有效率的措施,從而提高抗菌藥物的合理使用水平。

Objective To analyze the utilization of antibiotics in First Teaching Hospital of Tianjin University of Traditional Chinese Medicine in 2014, and to provide valuable reference for rational use of antibiotics. Methods Antibiotic prescriptions of every month in outpatient and emergency department, and inpatients in First Teaching Hospital of Tianjin University of Traditional Chinese Medicine in 2014 were summarized. And usage amount, department distribution, application situation, and irrational antibiotic prescriptions was reviewed and analyzed. Results The usage amount of outpatient and emergency department, and inpatients accounted for 1.8% and 9.4% of total usage amount of drugs. The use of antibiotics is relatively common. And the administration departments were concentrated on department of pediatrics, emergency, and gynecology in outpatient and emergency department. For inpatients, they were concentrated on department of pediatrics and oncology. For the whole hospital, second line of antibiotics accounted for the highest usage amount and defined daily dose. The varieties of antibiotics were mainly focused on cephalosporins, macrolides, quinolones, aminoglycosides, new triazoles, and etc. Furthermore, the reasons of unreasonable descriptions were that indications were not conformity with the disease, dosing method and dosage were improper, and course of treatment and drug combination were unreasonable. Conclusion For the usage of antibiotics in outpatient and emergency department, and inpatients, specific training to clinicians, reward and penalty system, enhancing drug management, reasonable drug application, and optimized variety of the antibiotics selection are the solutions for the better drug management and application, and to improve the level of reasonable application of antibiotics.