张翕 杨瑶瑶 周越 杜可欣 胡琳 郑波 管晓东 海沙尔江·吾守尔 史录文

中圖分类号 R969.3;R95 文献标志码 A 文章编号 1001-0408（2021）16-1921-05

DOI 10.6039/j.issn.1001-0408.2021.16.01

摘 要 目的：为科学监管和合理应用抗菌药物提供参考。方法：检索各省卫生行政部门官方网站、中国知网、公共搜索引擎等平台，收集并汇总2012年4月-2021年3月省级抗菌药物分级管理目录，对各省抗菌药物分级管理目录的差异和调整情况进行描述性统计分析。结果与结论：2012年4月以来，全国共有30个省份出台了抗菌药物分级管理目录，其中仅有10个省份对分级管理目录进行过调整。各省现行分级管理目录中，纳入抗菌药物品种数最多的是江苏（208种），最少的是新疆（101种）;在各省目录包含的253种抗菌药物中，134种在各省分级管理目录中存在2种管理级别，19种在各省分级管理目录中存在3种管理级别。各省分级管理目录调整次数最多的10种抗菌药物主要涵盖硝咪唑类、β-内酰胺类复方制剂和喹诺酮类，且存在同种抗菌药物同时被调入或调出目录、上调或下调管理级别的现象。我国各省分级管理目录更新进度缓慢，且目录遴选药品数量和分级差异均较大，建议各省卫生行政部门应持续性地优化、完善抗菌药物分级管理目录，形成分级管理目录动态调整和省间证据共享的长效机制，从而进一步规范抗菌药物的临床应用，遏制细菌耐药。

关键词 抗菌药物管理;分级管理目录;分析

Analysis of Provincial Antibiotic Classification Management Lists in China

ZHANG Xi1，YANG Yaoyao1，ZHOU Yue1，DU Kexin1，HU Lin1，ZHENG Bo2，GUAN Xiaodong1，Haishaerjiang·Wushouer1，3，SHI Luwen1，3（1. School of Pharmaceutical Sciences， Peking University， Beijing 100191， China; 2. Institute of Clinical Pharmacology， Peking University First Hospital， Beijing 100191， China; 3. International Research Center for Medicinal Administration， Peking University， Beijing 100191， China）

ABSTRACT   OBJECTIVE： To provide reference for scientific management and rational use of antibiotics. METHODS：Provincial antibiotic classification management lists were retrieved from official websites of provincial health administrative departments， CNKI and other search engines from Apr. 2012 to Mar. 2020. The difference and adjustment of those lists were analyzed descriptively. RESULTS & CONCLUSIONS： Since April 2012， 30 provinces released provincial antibiotic classification management lists， among which only 10 provinces updated the lists. In the provincial classification management lists， the list of Jiangsu included the most antibiotics （208 kinds）， that of Xinjiang involved the least （101 kinds）. Among the 253 antibiotics included in the provincial lists， 134 antibiotics had two management levels， and 19 antibiotics had three management levels. The 10 antibiotics with the most times of adjustment in the provincial lists mainly include nitimidazoles， β-lautam compound preparations and quinolones. There was the phenomenon that the same antibiotics were simultaneously included or withdrawn from the lists， and the grading management level was increased or decreased in the provincial adjustment. Provincial classification management lists updated slowly in China， and the quantity and classification of drugs selected in the list were quite different. It is suggested that provincial health administrative departments should continuously optimizeand improve classification management list of antibiotics， and form a long-term mechanism of dynamic adjustment of list and inter-provincial evidence sharing， so as to promote the rational clinical use of antibiotics， and curb bacterial resistance.

KEYWORDS   Antibiotic management; Classification management list; Analysis

抗菌药物不合理应用引发的细菌耐药问题已成为当今世界公共卫生体系面临的重大危机之一[1]。……