目的 分析天津医科大学第二医院住院患者特殊级抗菌药物的使用情况，探讨管理中存在的问题与对策，促进临床合理用药。方法 采用回顾性分析法，通过HIS信息系统调取2015—2016年天津医科大学第二医院住院患者特殊级抗菌药物的使用数据及资料，进行比较分析。并使用鱼骨图探讨特殊级抗菌药使用中存在问题与对策。结果 2015—2016年特殊级抗菌药物临床使用率基本稳定，特殊级抗菌药物用药频度（DDDs）控制在合理范围内，注射用头孢噻利、利奈唑胺注射液用量增长，科室分布变化不大，联合用药现象较为普遍，以2种药物联用为主，且联合用药呈下降趋势。使用鱼骨图分析得出特殊级抗菌药物临床使用中存在药物选择、疗程剂量、药物配伍、联合用药4个方面问题。结论 天津医科大学第二医院特殊级抗菌药物的使用较为合理，但也存在部分问题。需要通过医师、药师各司其职，依赖医院行政干预，借助信息系统辅助管理，发现问题解决问题，使特殊级抗菌药物临床使用逐步合理。

Objective To analyze the application of special class antimicrobial drugs in inpatients of the Second Hospital of Tianjin Medical University, and to discuss the problems existing in the management of the special class antimicrobial drugs, so as to offer reference for clinical rational use. Methods Retrospective analysis was adopted, the application data of the special class antimicrobial drugs in inpatients of the Second Hospital of Tianjin Medical University from 2015 to 2016 was extracted from the hospital information system (HIS). The changes and tendency of application were compared and analyzed. The problems existing in the application of the special class antimicrobial drugs and the solutions for the problems were discussed by fish-bone diagram. Results The usage ratio of special class antimicrobial drugs was basically stable from 2015 to 2016, and the DDDs were still maintained in a reasonable range. The usage of Cefoselis for injection and Linezolid Injection increased and the department distribution kept steadily. While combination was relatively common, most with two kinds of drugs combination, and it had a down trend. In the procedure of drawing fish-bone diagram, the application regularity of the special class antimicrobial drugs was confronted mainly with problems of four aspects. The main types of unreasonable medicine were drug choice, medicinal course and dosage, drug compatibility, and drug combination. Conclusion The use of special class antimicrobial drugs in the Second Hospital of Tianjin Medical University from is reasonable on the whole, yet there are still some problems. Thus both doctors and pharmacists should perform their roles, with the help of intervening measures by the hospital and the use of information management system, to promote the application of special class antimicrobial drugs to be more reasonable.