目的 调查武警河北省总队医院超药品说明书用药现状，对存在的安全隐患进行分析，提出防范建议，为降低用药风险，规范管理提供理论依据。方法 对本院2019年1～12月门诊处方、住院医嘱超说明书用药情况进行回顾性统计分析。结果 本院超说明书用药主要表现在超适应证、超适应人群和给药途径等方面，90%以上超说明书用药有证据支持，但也有部分超说明书用药没有指南推荐和文献支持，药品说明书之外的用法值得进一步商榷。结论 超药品说明书用药现象客观存在且不可避免，它涉及到药品有效性、医疗执业风险和安全隐患，因此制定合理的管理策略，强化超说明书用药管理的规范化、制度化是当前亟待解决的问题。

Objective To investigate the current status of the use of beyond the drug instructions, so as to analyze the security hidden danger, which provides the theoretical basis for reducing the risk of drug use and standardizing the management.Methods A retrospective statistical analysis was carried out on the prescriptions of outpatient and medical advice in a hospital in 2019. Results The main manifestations of off label drug use in the hospital are over indication, over adapted population and route of administration, More than 90% of off label drugs are supported by evidence, but some off label drugs are not recommended by guidelines and supported by literature. The usage of off label drugs is worthy of further discussion.Conclusion The phenomenon of off label drug use is objective and inevitable, which involves drug effectiveness, medical practice risk and safety risks. Therefore, it is urgent to formulate reasonable management strategies and strengthen the standardization and institutionalization of off label drug use management.

R969.3