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目的分析2010—2012年住院患者抗菌药物的使用情况,为临床规范合理使用抗菌药物提供参考和依据。方法随机抽取昆明医科大学第二附属医院2010—2012年出院患者5862例作为研究对象,2010年1897例、2011年2059例、2012年1906例,采用自制调查表从研究对象出院病历中获取抗菌药物相关资料,包括是否使用抗菌药、抗菌药物种类、用途、病原学送检情况等,对比分析各年抗菌药物使用情况及合理性。结果 2010—2012年抗菌药物使用率分别是73.06%、71.15%和64.38%,种类上以头孢菌素居多(>50%),2011年和2012年较2010年大环内酯类使用比例上升,喹诺酮类使用比例下降(P<0.05),一代、二代头孢菌素的使用有所增加。抗菌药物以单用药为主,2012年较2010年、2011年单一用药比例明显上升,三联及以上用药情况明显下降(P<0.05)。治疗用抗菌药物的使用比例逐年上升,预防用抗菌药物的比例逐年减少(P=0.013)。2011年、2012年治疗用抗菌药物的送检率较2010年均明显提高(P<0.001)。结论该院住院患者抗菌药物使用渐趋合理,但在控制抗菌药物用量,尤其是减少预防用抗菌药物,提高治疗用抗菌药物病原学送检率等方面仍需进一步加强,以持续促进抗菌药物的合理规范应用。
Objective To analyze the use of antibacterials in inpatients from 2010 to 2012 and provide references and evidences for rational use of antibacterials in clinical practice. Methods A total of 5862 discharged patients from the Second Affiliated Hospital of Kunming Medical University from 2010 to 2012 were selected as the research objects. In 2010, 1897 cases, 2059 cases in 2011 and 1906 cases in 2012 were collected. The self-made questionnaires were used to obtain antibacterial drugs Relevant information, including whether or not to use antibacterial drugs, types of antibacterial drugs, uses, etiological examination and so on, comparative analysis of antimicrobial use and rationality of each year. Results The antibacterials utilization rates in 2010-2012 were 73.06%, 71.15% and 64.38%, respectively. Most of the antibacterials were cephalosporins (> 50%), and the proportion of macrolides increased in 2011 and 2012, The use of quinolones decreased (P <0.05), and the use of first- and second-generation cephalosporins increased. Antibiotics were dominated by monotherapy. In 2012, the proportion of monotherapy increased significantly in 2012 and 2011, and the dosage of triptolide and above significantly decreased (P <0.05). The proportion of therapeutic antibacterials increased year by year, and the proportion of prophylactic antibacterials decreased year by year (P = 0.013). In 2011 and 2012, the delivery rate of therapeutic antibiotics was significantly higher than that of 2010 (P <0.001). Conclusion Inpatient use of antimicrobial agents in this hospital is becoming more and more reasonable. However, the use of antimicrobial agents should be further strengthened in order to control the amount of antimicrobial agents, in particular to reduce the amount of antimicrobial agents used for prophylaxis and to increase the etiological rate of antimicrobial agents for treatment. Rationalize the application.