2009-2011年杭州地区抗深部真菌感染药利用分析

Analysis of the Utilization of Antifungal Agents to Invasive Fungal Infection from 2009 to 2011 in Hangzhou Area

关键词:  抗真菌药  多烯类  三唑类  棘白霉素类  用药频度  日均费用  金额分析法

Key words:  antifungal agent  polyene  triazoles  echinocandins  DDDs  DDC  consumption analysis

摘要:

目的 评估2009—2011年杭州地区抗深部真菌感染药的临床应用状况，为临床合理应用抗真菌药提供依据。方法 根据杭州地区25家医院2009年—2011年的抗真菌药消耗数据，采用金额分析法、用药频度(DDDs)分析法、日均费用(DDC)分析法进行统计分析。结果 杭州地区25家医院抗真菌药购药总金额3年呈逐年上升趋势，分别增长35.56%和26.13%。其中米卡芬净为108.3%和78.77%；伏立康唑为78.31%和84%；卡泊芬净为58.5%和70.22%；氟康唑为18.82%和-14.65%；伊曲康唑为7.77%和-33.22%；两性霉素B 为-3%和-50.01%；DDDs最大的是伊曲康唑；DDC最高为米卡芬净。结论 杭州地区抗真菌药市场呈明显增长趋势，药品消费结构稳定，早年上市的产品出现负增长，新近上市的药品快速增长，涨跌互现。临床医师应严格依据感染菌及药敏结果，合理选择抗真菌药，避免耐药菌的发生和扩散，延长抗真菌药的使用周期。

Abstract:

OBJECTIVE To assess the clinical utilization of antifungal agents to invasive fungal infection during 2009-2011 in Hangzhou area so as to provide evidence for clinical rational usage of antifungal agents. METHODS Antifungal consumption data according to the Hangzhou area of 25 hospitals from 2009 to 2011, the amount of analysis, DDDs analysis, the average daily costs(DDC) analysis were used for statistical analysis. RESULTS The total consumption of antifungal agents in Hangzhou area showed an up trend over the past 3 years, increased by 35.56% and 26.13%, with 108.3% and 78.77% of micafungin, 78.31% and 84% of voriconazole, 58.5% and 70.22% of caspofungin, 18.82% and -14.65% of fluconazole, 7.77% and -33.22% of itraconazole, -3% and -50.01% of amphotericin B. The top DDDs was itraconazole. The top DDC was micafungin. Moreover, the consumption of voriconazole increased rapidly. CONCLUSION The consumption of the antifungal agents in Hangzhou area has increased over 3 years, with negative increase for older products and larger positive increase for newer products. Doctors should pick the antifungal drug by the infected bacteria and microbial sensitivity tests to prevent the spreading of drug resistant bacteria and to prolong the use cycle of the drugs.