湖南武陵山片区56所乡镇卫生院抗菌药物使用现状调查

Current status of antimicrobial application in 56 township hospitals in Hunan Wuling mountain area

摘要:

目的调查湖南武陵山片区56所乡镇卫生院抗菌药物的使用现状。方法随机抽取湖南武陵山片区56所乡镇卫生院门诊处方13 348张，非手术患者病历1 288份，手术患者病历280份，调查其抗菌药物使用情况。结果门诊患者、住院非手术患者、住院手术患者抗菌药物使用率为53.01%、87.97%、98.57%，联合用药率分别为19.57%、46.96%、39.86%。I类切口手术患者预防性使用抗菌药物比率为96.94%，联合用药率为36.84%。住院患者抗菌药物使用强度124.92 DDDs/100人·天。56所卫生院门诊处方中抗菌药物使用8 573种次，使用频率居前5位的分别为阿莫西林、头孢曲松、阿莫西林/克拉维酸钾、左氧氟沙星和克林霉素。 结论湖南武陵山片区乡镇卫生院普遍过度使用、不合理使用抗菌药物。医务人员应加强学习，认真执行抗菌药物管理相关规定；卫生行政主管部门应加强对卫生院抗菌药物临床应用的监督管理，促进乡镇卫生院抗菌药物的合理使用。

Abstract:

ObjectiveTo investigate antimicrobial application in 56 township hospitals in Hunan Wuling mountain area. Methods13 348 outpatient prescriptions，1 288 medical records of nonoperated patients, and 280 medical records of operated patients in 56 township hospitals in Hunan Wuling mountain area were selected randomly, antimicrobial application was surveyed. ResultsAntimicrobial usage rates in outpatients, nonoperated inpatients, and operated inpatients were 53.01%, 87.97%, and 98.57% respectively, and the percentage of combined antimicrobial agents were 19.57%, 46.96%, and 39.86% respectively. The percentage of antimicrobial prophylaxis in patients undergoing type I incision surgery was 96.94%, combined antimicrobial usage rate was 36.84%. Antimicrobial use density in  hospitalized patients was 124.92 DDDs/100 patient days. 8 573 antimicrobial agents were prescribed in outpatient prescriptions of 56 hospitals, the top 5 frequently used antimicrobial agents were amoxicillin, ceftriaxone, amoxicillin/clavulanate potassium, levofloxacin, and clindamycin. ConclusionAntimicrobial agents are overused and irrationally used in township hospitals in Hunan Wuling mountain area. Health care workers should strengthen learning, conscientiously implement the relevant regulations on antimicrobial management; health administrative departments should strengthen the supervision and management on clinical application of antimicrobial agents, and promote the rational use of antimicrobial agents in township hospitals.