目的 分析2014年天津中医药大学第一附属医院抗菌药物的使用情况,为合理使用抗菌药物提供依据。方法 总结天津中医药大学第一附属医院2014年每月门急诊及住院患者的抗菌药物处方,对抗菌药物的用药金额、使用科室、应用情况及不合理使用问题等进行统计分析。结果 2014年门急诊、住院病区抗菌药物的用药金额分别占总用药金额的1.8%、9.4%;抗菌药物的使用患者较普遍,门急诊主要集中于儿科、急症科和妇科,住院病区主要集中于儿科和肿瘤科;从全院整体上看,本年度用药金额和用药频度最高的均为二线抗菌药物;使用的抗菌药物品种多集中在头孢类、大环内酯类、喹诺酮类及氨基糖苷类、新型三唑类等。另外,处方不合理的原因有所开药物的适应症与病情不符、给药方法和剂量不当、用药疗程和药物联用不合理等。结论 结合门急诊及住院病区抗菌药物的使用情况,针对性地加强医师抗菌药物的培训和合理使用,加强管理,建立奖罚制度,优化筛选抗菌药物的品种,以找出更好更充分的利用药物有效率的措施,从而提高抗菌药物的合理使用水平。

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.