李海燕　胡　斌西安市第四医院药剂科，陕西西安 710004

2013～2015年西安地区13家三级医院抗菌药物使用情况调查与分析

李海燕胡斌
西安市第四医院药剂科，陕西西安 710004

目的调查2013～2015年西安地区13家三级医院抗菌药物使用现状，以期为“抗菌药物临床应用专项整治活动”后抗菌药物的使用及管理提供依据。方法 对2013～2015年西安地区13家三级医院住院患者抗菌药物销售总金额、用药频度（DDDs）、抗菌药物使用率、抗菌药物使用强度（AUD）、抗菌药物销售金额占药品总金额比率（以下简称“抗菌药物销售金额比”）、Ⅰ类切口手术患者抗菌药物预防使用情况、销售金额前10位抗菌药物用药频度及日均费用（DDC）、门急诊患者抗菌药物处方比例等数据进行统计分析。结果3年来西安地区三级医院住院患者抗菌药物销售总金额、AUD、抗菌药物销售金额比呈逐年上升趋势。2013～2015年13家医院住院患者抗菌药物使用率为48.95%、48.24%、51.29%；AUD为33.75、40.33、41.19；抗菌药物销售金额比为15.45%、15.80%、16.09%。Ⅰ类切口手术患者抗菌药物预防使用情况不乐观，4家医院连续3年预防用药比例超过30%。头孢菌素类抗菌药物占主导地位，连续3年占抗菌药物DDDs份额30%以上。门、急诊患者抗菌药物处方比例基本达标。结论西安地区医疗机构应逐步建立完善抗菌药物临床应用管理长效工作机制，促进抗菌药物临床应用能力和管理水平的持续改进和提高。

抗菌药物；销售金额；DDDs；DDC；持续改进

［Abstract］Objective To investigate the utilization of antibacterial drugs of 13 tertiary hospitals in Xi′an City from 2013 to 2015，and to provide reference for rational use and management of antibacterial drugs after“Clinical application of antibacterial drugs special rectification activities”.Methods The utilization of antibacterial drugs in 13 tertiary hospitals from Xi′an City from 2013 to 2015 was analyzed statistically in respects of the cost of total antibacterial drugs purchasing，DDDs，the antibacterial drugs using rates of inpatients and the antibacterial use density（AUD）of inpatients，the proportion of antibacterial drugs sum，the prophylactic antibacterial using condition in patients with typeⅠincision operation，the DDDs and DDC of the top 10-ranked antibacterial drugs and the antibacterial drugs using rates of out-patients and emergency patients.Results The cost of total antibacterial drugs purchasing，AUD and the proportion of antibacterial drugs sum increased year by year from 2013 to 2015.The antibacterial drugs using rates of inpatients was 48.95%，48.24%，51.29%，AUD of inpatients was 33.75，40.33，41.19，and the proportion of antibacterial drugs sum was 15.45%，15.80%，16.09%respectively.The prophylactic antibacterial using condition in patients with typeⅠ incision operations was not optimistic.The prophylactic antibacterial using rates of 4 hospitals exceeded 30% from 2013 to 2015.Cephalosporin took up more than 30%DDDs of all antibacterial drugs.The antibacterial drugs using rates of out-patients and emergency patients of 13 tertiary hospitals reached the basic standard.Conclusion A long-term management mechanism of clinical use of antibiotics is needed to be established in Xi′an City，in order to improve the management of clinical use of antibiotics in hospitals.

［Key words］Antibacterial drugs；The total antibacterial drugs purchasing；DDDs；DDC；Continual improvement

2011年4月，原卫生部在全国范围内启动了为期3年的“抗菌药物临床应用专项整治活动”（以下简称“整治活动”）［1］，旨在规范抗菌药物临床应用。……