李 锦



全国抗菌药物临床应用专项整治活动开展以来上海市社区医院使用情况调查

李 锦

【摘要】目的 了解“全国抗菌药物临床应用专项整治活动”开展以来上海地区社区卫生服务中心的抗菌药物门诊合理使用情况。方法 收集上海市14家综合性一级医院2012～2014年含抗菌药物在内的原始电子处方，采用Excel对各项处方数据进行汇总，计算用药频度、DDDs、年均增长率（CAGR）等并进行分析。结果 3年来，14家样本医院抗菌药物处方数及处方金额呈逐渐下降趋势。抗菌药物处方张数占比、金额占比呈逐渐下降趋势。DDDs排序前10位的药品中，属二代头孢菌素类的有5个，上升最快的是头孢克洛，CAGR达6．5%，从处方张数来看是非限制使用类所占比例最高，超过75%以上，限制使用类次之，特殊使用类除2012年占有极少量外，2013、2014年没有出现。结论 经过3年的专项整治，抗生素使用在上海基层医院得到改善，使用情况已趋于稳定，向合理使用方向发展，但仍需加强监控，防止反弹。【关键词】上海社区卫生服务中心；抗菌药物；合理应用；处方分析

Objective The purpose of this survey is to understand the“national special clinical application of antibacterial drugs”to carry out community health service centers in shanghai since the usage of antibacterial drugs． Methods We collected 14 comprehensive level of shanghai hospital from 2012 to 2014，including antimicrobial agents on the original electronic prescriptions，and used Excel to make all the data together，calculate the frequency，DDDs and average annual growth rate（CAGR）were calculated． Results In the past 3 years，14 sample hospitals in the use of antibacterial drugs prescription showed a trend of gradual decline in the number and amount． The amount and the proportion of the use of antimicrobial agents were becoming more and more low． Five belong to the second generation cephalosporin drugs ranked in the top 10 in the DDDS． Useing the number of cefaclor quantity is the fastest rising and CAGR is taking up 6．5% of the total number． The restrictions on the use of class proportion is among the highest in the prescribed number of sheets which is taking up more than 75%，the second was prescription drugs，special using of drugs was just be used in 2012． Conclusion After three years’ rectification，antibiotic use basic-level in shanghai’s hospitals have markedly improved，using situation has become stabilized，using methods tend to be more reasonable，but it still need to strengthen the monitoring，incase of rebounding．

【Key words】 Shanghai community health service centers，Antimicrobial agents，Reasonable application，Prescription analysis

上海各社区卫生服务中心作为最基层的医疗机构，在“全国抗菌药物临床应用专项整治活动”开展以来抗菌药物使用情况，采取何种方法来评价专项整治以来抗菌药物合理使用情况，对促进和提高基层医疗机构合理用药水平有着极为重要的现实意义。本文采集社区卫生服务中心的抗菌药物处方数据，按处方量、处方金额、管理类别等进行统计、分析，以考察专项整治活动以来的使用情况，为进一步合理用药提供科学的依据。……