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[摘要]
目的 分析2014—2017年六安市人民医院住院患者抗菌药物的使用情况。方法 调取2014—2017年六安市人民医院抗菌药物的相关用药信息,并从多个角度对抗菌药物的使用率、使用强度(AUD)、用药频度(DDDs)、日均费用(DDC)进行回顾性统计分析。结果 抗菌药物给药途径以静脉注射为主,2014—2017年,抗菌药物使用率和AUD均下降,但各类品种选择结构有明显变化。总体上β-内酰胺类药物选用比例有所下降,但在住院患者抗菌药物中β-内酰胺类药物仍然DDDs及占比最高。第1、3、4代头孢的DDDs总体呈波动式下滑的趋势,只有第2代头孢的DDDs总体上呈上升的趋势,由于第3、4代头孢DDDs占比较少,第2代头孢取代第1代头孢的趋势比较明显,第2代头孢中头孢呋辛有取代头孢替安的趋势。β内酰胺/β内酰胺酶抑制剂复方制剂中哌拉西林他唑巴坦大幅增长,头孢哌酮钠舒巴坦钠、阿莫西林克拉维酸钾大幅下降。碳青霉烯类和头霉素类出现明显增长。单环β内酰胺类氨曲南的DDDs出现大幅下降。氟喹诺酮类药物中的盐酸莫西沙星氯化钠注射液、大环内酯类中的阿奇霉素干混悬剂逐年增长较为迅速,抗真菌药物伏立康唑(国产)、替考拉宁和利奈唑胺DDDs均显著增加。结论 2014—2017年六安市人民医院抗菌药物的管理是有效的,但应注意品种结构选择的变化及抗菌药物销售金额的增长,尤其关注哌拉西林他唑巴坦、头孢西丁钠、莫西沙星、比阿培南、伏立康唑、替考拉宁、利奈唑胺的不合理用药问题。
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[Abstract]
Objective To study the utilization of antibacterial drugs for inpatients in Luan People's Hospital from 2014 to 2017. Methods The utilization of antibacterial drugs for inpatients in Luan People's Hospital from 2014 to 2017 was summarized retrospectively, and antibiotic use rate, the varieties, defined daily doses (DDDs), antibiotics use density (AUD), defined daily dose consumption (DDC) were analyzed from several angles. Results Intravenous drugs were the most choice. Antibiotic use rate and AUD decreased from 2014 to 2017, but the structure of varieties changed significantly. On the whole, the proportion of β-lactam drugs was decreased, but the proportion of β-lactams was the highest in the inpatients with antimicrobial agents. DDDs of the first, third, and fourth generation of cephalosporal generally showed a fluctuating downward trend, only DDDs of the second generation of cephalosporal showed an overall upward trend, because DDDs of the third and fourth generation of cephalosporal was relatively less, and the second generation of cephalosporal replaced the first generation of cephalosporal more obvious trend. Cefuroxime in the second generation of cephalosporins had a tendency to replace cefotiam. β-lactam/β-lactamase inhibitors compound:piperacillin tazobactam increased significantly, while cefoperazone sodium sulbactam sodium, and amoxicillin potassium clavulanate decreased significantly. Carbapenem and cephalomycin increased significantly. DDDs of monocyclic β-lactam aztreonam decreased significantly. Moxifloxacin hydrochloride sodium chloride injection in fluoroquinolones and azithromycin dry suspension in macrolides increased rapidly year by year. DDDs of voriconazole (domestic) in antifungal medications, linezolid, and telicoplanin were significantly increased.Conclusion The management of antibiotics in Luan People's Hospital from 2014 to 2017 was effective,but the change of variety structure and growth in sales amount of antimicrobials should be paid attention to, especially the irrational use of piperacillin tazobactam, cefoxitin sodium, moxifloxacin, biapenem, voriconazole, linezolid, and telicoplanin.
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