林娜

[摘要] 目的 研究分析抗生素在该科呼吸系统疾病临床中的合理应用情况。方法 随机抽取2015年7月—2017年7月期间该科呼吸系统疾病门诊中的有效处方500张进行研究，主要调查分析相关抗生素的使用率、相关品种、联合用药情况以及合理用药等情况。结果 500张有效处方中，共发现406张确定使用了抗生素，抗生素使用率为81.20%；整理发现，使用率排名前三的分别为头孢尼西钠（16.50%）、左氧氟沙星（16.26%）以及头孢他啶（14.53%），其总耗药量分别为428.43、204.61、1 780.84 g；总用药天数分别为452、412、425 d；用药频率（DDDs）与使用率呈正相关。406张抗生素处方中，一联用药共239张，占比58.87%；二联用药共167张，占比41.13%，无三联或者三联以上用药处方。结论 该科呼吸系统疾病抗生度用药基本符合安全、有效的原则，但仍旧存在不合理用药问题，应进行合理用药措施干预，提高抗生素用药的安全性。

[关键词] 抗生素；呼吸系统疾病；临床；合理应用

[中图分类号] R714 [文献标识码] A [文章编号] 1674-0742（2018）01（a）-0141-03

Analysis of the Rational Use of Antibiotics in the Respiratory System Diseases

LIN Na

Rehabilitation Department， Yunnan Provincial Military Rehabilitation Hospital， Kunming， Yunnan Province， 650221 China

[Abstract] Objective This paper tries to discuss and analyze the rational use of antibiotics in the respiratory diseases of this department. Methods A total of 500 valid prescriptions from this department during July 2015 to July 2017 were collected from randomized outpatient departments for respiratory diseases. The main investigation and analysis were conducted on the usage rate of antibiotics， related varieties， combination medication and rational drug use. Results Among the 500 valid prescriptions， 406 antibiotics were identified and the antibiotic utilization rate was 81.20%. It showed that the top three usage rates were cefonicid sodium （16.50%）， Levofloxacin （16.26%） and ceftazidime （14.53%） consumed 428.43 g， 204.61 g and 1 780.84 g respectively. The total days of treatment were 452 d， 412 d and 425 d respectively. The frequency of DDDs was positively correlated with the rate of use. Of the 406 antibiotic prescriptions， 239 were used in one combination， accounting for 58.87%； 167 were used in combination with two drugs， accounting for 41.13%. No triple or triple prescription was prescribed. Conclusion Antibiotic treatment of respiratory diseases in the department basically comply with safe and effective principles， but there is still the problem of irrational use of drugs， interventions should be reasonable medication to improve the safety of antibiotic medication.

[Key words] Antibiotics； Respiratory diseases； Clinical； Rational use

在醫院呼吸系统疾病的治疗中，抗生素扮演着不可替代的角色，对患者治疗的效果发挥重要的作用[1]。抗生素主要形成于细菌、真菌等其他微小生物的过程中，具有较强的抗病原性特征，存在一定的活性特点[2]。临床常见的抗生素为头孢菌素类、青霉素类、喹诺酮类以及大环内酯类等，呼吸性疾病作为感院内感染率较高的疾病，使用以上抗生素的概率极高[3]。但近年来对于抗生素的使用出现严重的不合理现象，一味地追求效果而忽略了其不良反应[4]。滥用、不合理使用现象导致细菌耐药性以及药源性疾病出现增加情况，不仅影响了患者的治疗效果，进一步加重了患者的经济负担[5]。……