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目的探讨医院实施抗菌药物专项整治活动成效与持续改进情况,为建立抗菌药物临床应用管理长效机制提供依据。方法采用回顾性分析方法,对2012年1-6月(整治前)、2012年7-12月(整治后)及2013年1月-2015年12月(持续改进阶段)的抗菌药物临床应用干预措施及用药情况进行统计分析。结果专项整治后,抗菌药物品种数由98种下降至49种;门诊抗菌药物使用率、门诊抗菌药物使用不合理率,住院抗菌药物使用率、Ⅰ类切口预防使用率、抗菌药物使用强度分别由整治前22.90%、4.21%、65.46%、43.56%、75.19DDDs/100人天下降到整治后17.30%、1.78%、52.80%、26.73%、46.38DDDs/100人天,抗菌药物用药结构发生明显变化;持续改进阶段各项干预指标及门诊用药情况保持良好,但住院使用强度及I类切口预防使用率仍小有波动。结论专项整治使抗菌药物临床应用趋于合理,但仍需进一步探索长效管理机制,促进临床持续规范应用抗菌药物。
Objective To investigate the effectiveness and continual improvement of hospitals in carrying out special rectification activities of antimicrobial agents and provide the basis for establishing a long-term mechanism of clinical application management of antimicrobial agents. Methods A retrospective analysis was conducted on the clinical application of antimicrobial agents in January-June 2012 (before remediation), July-December 2012 (after remediation) and January 2013-December 2015 (continuous improvement phase) Measures and medication for statistical analysis. Results After special rectification, the number of antibacterials decreased from 98 to 49. Outpatient antibacterials use rate, outpatient antibacterials use unreasonable rate, inpatient antibacterials use rate, Ⅰ type incision preventive use rate, and antibacterial drug use intensities were respectively Before remediation, there was a significant change in the medication structure of antimicrobial agents after 22.90%, 4.21%, 65.46%, 43.56%, 75.19DDDs / 100 people dropped to 17.30%, 1.78%, 52.80%, 26.73%, 46.38DDDs / 100 days after remediation ; The continuous improvement phase of the intervention targets and outpatient medication remained good, but the intensity of hospital use and I type of incision to prevent the use rate is still small fluctuations. Conclusion Special rectification tends to make the clinical application of antimicrobial agents more reasonable. However, it is still necessary to further explore long-term management mechanisms to promote the continuous use of antimicrobial agents in clinical practice.