抗菌药物不合理应用分析及药学监护效果探讨
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摘要
目的:了解深圳市宝安区中医院(以下简称"我院")抗菌药物不合理应用情况,探讨药学监护在抗菌药物临床应用中的作用。方法:选取2016年(药学监护实施前)、2017年(药学监护实施后)我院采用抗菌药物治疗的门诊患者各500例。针对2016年抗菌药物不合理应用情况,制订药学监护对策并于2017年开始实施;比较药学监护实施前后抗菌药物不合理使用率、患者用药依从性的差异。结果:药学监护实施前,抗菌药物不合理使用率为6.80%(34/500),涉及无明确指征用药、药物配伍不合理、用药疗程不合理、给药时间不合理、溶剂选择不合理及给药剂量不合理;药学监护实施后,抗菌药物不合理使用率为0.60%(3/500),明显低于药学监护实施前,差异有统计学意义(P<0.05),仅无明确指征用药2例、用药疗程不合理1例。药学监护实施后患者的总用药依从率为97.00%(485/500),明显高于药学监护实施前的86.40%(432/500),差异有统计学意义(P<0.05)。结论:抗菌药物的临床应用存在较多不合理情况,需积极落实药学监护对策,促进抗菌药物的合理应用,提高患者用药依从性。
OBJECTIVE: To investigate the irrational application of antibiotics in Baoan Hospital of Traditional Chinese Medicine(hereinafter referred to as "our hospital"), to explore the role of pharmaceutical care in clinical application of antibiotics. METHODS: 500 cases of outpatients with applied of antibiotics in 2016(before the implementing of pharmaceutical care) and 2017(after the implementing of pharmaceutical care). Aimed at the irrational application of antibiotics in 2016, our hospital had formulated countermeasures of pharmaceutical care and come into operation in 2017; the differences in irrational rates of antibiotics and medication compliance of patients between before and after the implementing of pharmaceutical care were compared. RESULTS: Before the implementation of pharmaceutical care, the irrational use rate of antibiotics was 6.80%(34/500), mainly including no clear indications, irrational drug compatibility, improper drug treatment courses, improper administration time, irrational solvent selection and improper administration time. After implementation of pharmaceutical care, the irrational use rate of antibiotics was 0.60%(3/500), which was significantly lower than that before the implementation of pharmaceutical care(P<0.05), there were only 2 cases with no clear indications and 1 case with irrational treatment course. After the implementation of pharmaceutical care, the total medication compliance rate was 97.00%(485/500), which was significantly higher than 86.40%(432/500) before the implementation of pharmaceutical care, the difference was statistically significant(P<0.05). CONCLUSIONS: There are many irrational problems in the clinical application of antibiotics. Therefore, it is necessary to actively implement pharmacological care, promote the rational application of antibiotics and improve the medication compliance.
OBJECTIVE: To investigate the irrational application of antibiotics in Baoan Hospital of Traditional Chinese Medicine(hereinafter referred to as "our hospital"), to explore the role of pharmaceutical care in clinical application of antibiotics. METHODS: 500 cases of outpatients with applied of antibiotics in 2016(before the implementing of pharmaceutical care) and 2017(after the implementing of pharmaceutical care). Aimed at the irrational application of antibiotics in 2016, our hospital had formulated countermeasures of pharmaceutical care and come into operation in 2017; the differences in irrational rates of antibiotics and medication compliance of patients between before and after the implementing of pharmaceutical care were compared. RESULTS: Before the implementation of pharmaceutical care, the irrational use rate of antibiotics was 6.80%(34/500), mainly including no clear indications, irrational drug compatibility, improper drug treatment courses, improper administration time, irrational solvent selection and improper administration time. After implementation of pharmaceutical care, the irrational use rate of antibiotics was 0.60%(3/500), which was significantly lower than that before the implementation of pharmaceutical care(P<0.05), there were only 2 cases with no clear indications and 1 case with irrational treatment course. After the implementation of pharmaceutical care, the total medication compliance rate was 97.00%(485/500), which was significantly higher than 86.40%(432/500) before the implementation of pharmaceutical care, the difference was statistically significant(P<0.05). CONCLUSIONS: There are many irrational problems in the clinical application of antibiotics. Therefore, it is necessary to actively implement pharmacological care, promote the rational application of antibiotics and improve the medication compliance.
引文
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[14] 冒群,徐爱宁.某医院2016年Ⅱ类切口围手术期预防性应用抗菌药物的合理性分析[J].解放军预防医学杂志,2017,35(10):1301-1303.
[15] 房师荣,王广征,杨玉珍,等.抗菌药物门诊处方临床应用分析[J].中华医院感染学杂志,2016,26(8):1901-1902,1905.
[2] 林意菊,聂彩霞,邹治木,等.医院专项整治前后抗菌药物使用强度与合理用药分析[J].中国药业,2016,25(11):77-81.
[3] 凡小燕,张燕娜.某院2016年门诊抗菌药物处方点评及合理用药分析[J].中国药业,2017,26(24):74-76.
[4] 台磊.898张门诊抗菌药物处方点评与分析[J].中国医院用药评价与分析,2017,17(11):1580-1581,1584.
[5] 梁志斌.河池市第三人民医院门诊抗菌药物不合理应用分析[J].中国医院用药评价与分析,2015,15(2):226-227.
[6] 柴健,张洁.临床药师干预我院呼吸内科抗菌药物使用的效果评价[J].中国药房,2017,28(26):3720-3722.
[7] 芮丽娜,郭晓松,位宁,等.临床药师参与重症胰腺炎患者抗菌药物治疗的药学监护[J].中国医院用药评价与分析,2017,17(1):135-137,140.
[8] 刘莉,徐婷婷,汤拥军,等.临床药师干预抗菌药物使用的效果分析[J].中国药房,2016,27(32):4589-4591.
[9] 彭敏.抗菌药物不合理应用的影响因素及干预方式研究[J].解放军预防医学杂志,2017,35(6):595-597.
[10] 宋攀,黄垂国,李云龙,等.抗菌药物在外科的不合理应用及对策[J].中华医院感染学杂志,2017,27(3):717-720.
[11] 任正,郭苗,张吉,等.1560例住院患者抗菌药物应用情况分析[J].江苏医药,2016,42(15):1718-1720.
[12] 赵慧,王丽,冷红春,等.急诊新生儿抗菌药物应用的临床分析[J].中华医院感染学杂志,2016,26(15):3567-3568,3574.
[13] 赵晓杰,刘庆彩.药事管理对医院抗菌药物合理应用的影响[J].新乡医学院学报,2018,35(4):330-332.
[14] 冒群,徐爱宁.某医院2016年Ⅱ类切口围手术期预防性应用抗菌药物的合理性分析[J].解放军预防医学杂志,2017,35(10):1301-1303.
[15] 房师荣,王广征,杨玉珍,等.抗菌药物门诊处方临床应用分析[J].中华医院感染学杂志,2016,26(8):1901-1902,1905.