谢经 谭喜莹 姚毅 张小萍 周竹琇

[摘要] 目的 调查分析江苏省中医院（以下简称“我院”）住院患者特殊使用级抗菌药物的临床使用情况，为合理应用和科学管理提供依据。 方法 对2016年1～12月我院4234例应用特殊使用级抗菌药物的患者资料及药品信息进行回顾性分析。 结果 特殊使用级抗菌药物应用较多的科室是呼吸科和血液内科。应用特殊使用级抗菌药物治疗前微生物送检率为58.03%，未达国家标准。男性人次多于女性；老年人居多，平均用药年龄为68岁。平均用药天数为7 d，以呼吸道感染为主。用药频度居前的是头孢吡肟、亚胺培南/西司他丁、头孢噻利。 结论 我院住院患者的特殊使用级抗菌药物应用基本合理，但仍存在不合理之处，需进一步加大管理力度。

[关键词] 特殊使用级抗菌药物；住院患者；应用分析；合理应用

[中图分类号] R969.3 [文献标识码] A [文章编号] 1673-7210（2018）02（b）-0049-05

[Abstract] Objective To provide reference for clinical rational use and scientific management through analyzing the utilization of antibiotics for special use of inpatients in Jiangsu Province Hospital of TCM （“our hospital” for short）. Methods The data and drug information of 4234 patients treated with antibiotics for special use in our hospital from January to December in 2016 were analyzed retrospectively. Results Such drugs were most applied in Department of Pneumology and Hematology. The rate of microbiological examination was 58.03%， which did not reach the national standard. The number of men was more than women. Most patients were the elder whose mean age was 68 years old. The mean time of usage was 7 days. Most patients were respiratory infections. The frequency of drug use in the first three was Cefepime， Imipenem / Cilastatin and Cefoselis respectively. Conclusion The application of antibiotics for special use for inpatients in our hospital is basically reasonable， but also needs to be further strengthened.

[Key words] Antibiotics for special use； Inpatient； Application analysis； Rational use

國家卫生计生委（原国家卫生部）《抗菌药物临床应用指导原则》[1]、《卫生部办公厅关于进一步加强抗菌药物临床应用管理的通知》[2]及《抗菌药物临床应用管理办法》（原卫生部第84号令）[3]等相关法规要求医疗机构建立健全抗菌药物的分级管理制度，将抗菌药物分为非限制使用级、限制使用级和特殊使用级。其中特殊使用级抗菌药物是指不良反应明显、不宜随意使用或临床需要倍加保护以免细菌过快产生耐药而导致严重后果的抗菌药物；其疗效或安全性任何一方面的临床资料尚较少，或并不优于现用药物者。……