目的 对咸阳市中心医院特殊使用级抗菌药物的临床应用情况及用药趋势进行分析，为其规范化管理和临床合理用药提供参考。方法 对2016-2018年咸阳市中心医院特殊使用级抗菌药物的使用数量、销售金额、用药频度（DDDs）、日均费用（DDC）及药品排序比（B/A）等进行统计和分析。结果 特殊使用级抗菌药物的总销售金额呈逐年递增趋势，其中美罗培南连续3年排名第1位。总体来看，使用最广泛的为抗革兰阴性菌的碳青霉烯类、其次为抗革兰阳性菌的糖肽类和噁唑烷酮类，抗真菌药使用最少。各药品的DDDs排名基本稳定。2016-2018年各药品的DDC有不同程度的下调，除两性霉素B脂质体以外，其余药品的使用成本均较高。去甲万古霉素、替加环素、两性霉素B脂质体的B/A值大于1，其余均小于1。结论 咸阳市中心医院特殊使用级抗菌药物的应用基本合理，医院应继续加强管理，充分发挥临床药师作用，有效遏制和减缓细菌耐药。

Objective To analyze the application and tendency of antibacterial agents in special use level in Xianyang Central Hospital, so as to provide reference for standard management and clinical rational use of drugs in Xianyang Central Hospital. Methods A retrospective study was conducted. The data of utilization of antibacterial agents in special use level in Xianyang Central Hospital from 2016 to 2018 were collected and analyzed statistically, and amounts, consumption sums, frequency of drug use (DDDs), defined daily cost (DDC), and drug sequence ratio (B/A) were calculated and analyzed. Results The total sales amount of antibacterial agents in special use level showed an increasing trend year by year, with meropenem ranking the first for three consecutive years. In general, the most widely used carbapenems against Gram-negative bacilli, followed by glycopeptides and oxazolidinone against Gram-positive cocci. Antifungal agents had the least use. The ranking of DDDs for each drug was basically stable. From 2016 to 2018, DDC of each drug was lowered to varying degrees. Except for amphotericin B liposome, the cost of other drugs was higher. B/A values of norvancomycin, tigecycline, and amphotericin B liposomes were greater than 1.00, and the rest were less than 1.00. Conclusion The application of antibacterial agents in special use level in Xianyang Central Hospital is basically reasonable. The hospital should continue to strengthen management and give full play to the role of clinical pharmacists, so as to effectively curb and slow down bacterial resistance.