目的 探討抗菌藥物專項整治前后西安市第一醫(yī)院抗菌藥物的使用情況，為臨床合理用藥提供參考。方法 采用前后對照的方法，對專項整治活動3年（2011-2013年）和專項整治后3年（2014-2016年）抗菌藥物使用情況進行分析。結(jié)果 抗菌藥物專項整治活動以來，醫(yī)院的接診量逐年增加，但抗菌藥物的消耗量、住院患者的使用率、使用強度、Ⅰ類切口預(yù)防用藥使用率、門急診抗菌藥物的使用率均有所下降。專項整治活動后，抗菌藥物的使用種類也有所變化，第2代頭孢、第3代頭孢+酶抑制劑、第4代頭孢、糖肽類、抗真菌類、氨曲南、克林霉素、夫西地酸的使用量呈逐年下降趨勢，分別下降了30.6%、37.2%、76.9%、25.5%、17.9%。93.3%、47%、81.3%；青霉素+酶抑制劑、第1代頭孢、第3代頭孢、碳青霉烯類、利奈唑胺的使用量呈增長趨勢，分別增長了63.9%、40.3%、124.9%、78.7%、109.9%。進入前10名的抗菌藥物相對集中，主要有頭孢類、大環(huán)內(nèi)酯類、左氧氟沙星注射液。結(jié)論 抗菌藥物專項整治活動在西安市第一醫(yī)院取得了較好的效果，但在抗菌藥物的使用上還可能存在用藥集中、廣譜抗菌藥物使用率高等問題，應(yīng)加強監(jiān)管，同時開展抗菌藥物使用與細菌耐藥的相關(guān)性研究，以提高抗菌藥物使用的合理性，降低耐藥菌的產(chǎn)生。

Objective To investigate the use of antimicrobial drugs before and after antibacterial treatment in Xi'an No. 1 Hospital, and to provide reference for rational drug use. Methods The use of antimicrobial drugs before (2011-2013) and after (2014-2016) antibacterial treatment was analyzed by before and after control method. Results Since antibacterial treatment, patients in the hospital increased year after year, but consume of antimicrobial drugs, utilization rate and intensity of inpatients, usage rate of prophylactic in class I incision, the ratio of antimicrobial drugs in Department of Outpatient and Emergency decreased. After antibacterial treatment, the varieties of antimicrobial drugs changed. Usage amount of second generation cephalosporin, third generation cephalosporin + enzyme inhibitor, fourth generation cephalosporin, glycopeptides, antifungal, aztreonam, clindamycin, fusidic acid decreased by 30.6%, 37.2%, 76.9%, 25.5%, 17.9%, 93.3%, 47.0%, and 81.3%. Usage amount of penicillin + enzyme inhibitor, first generation cephalosporin, third generation cephalosporin, carbapenems, linezolid increased by 63.9%, 40.3%, 124.9%, 78.7%, and 109.9%. Top ten antimicrobial drugs were relatively concentrated, and were mainly cephalosporins, macrolides, Levofloxacin Injection. Conclusion The antibacterial treatment gets good results in Xi'an No. 1 Hospital. However, there are still some problems such as dense medication, frequent use of broad-spectrum antimicrobial agents. Supervision should be strengthened, and the correlation research between usage of antimicrobial drugs and antimicrobial resistance should be carried out, in order to improve the rational use of antibiotics and reduce the generation of drug-resistant bacteria.