全国14家医院2014-2016年临床上抗菌药物使用情况分析

Investigation on Clinical Application of Antibacterial Drugs from 14 Tertiary Hospitals in China from 2014 to 2016

关键词:  抗菌药物  三甲医院  使用强度

Key words:  antibiotics  tertiary hospital  antibiotics use density

摘要:

目的 调查分析全国14家医院2014-2016年临床上抗菌药物使用情况。方法 通过分层整群随机抽样的方法对2014-2016年全国的14家三甲医院的抗菌药物使用情况进行调查和分析，包括抗菌药物的用药频度（DDDs）、日均费用（DDC）指标、序号比（B/A）、使用强度（AUD）和门诊处方情况等。结果 在2014-2016年期间，全国14家三甲医院抗菌药物的销售金额、AUD、抗菌药物使用频率和销售额比呈现逐年上升的趋势。抗菌药物销售金额排名前3的依旧为头孢菌素类和青霉素抗菌药物。另外，抗菌药物注射剂使用量在逐年下降。根据序号比和DDC指标分析，3年来，抗菌药物价格的合理程度逐年增高。在全国7个地区中，3年平均抗菌药物销售金额和使用率最高的是华东地区，其次是华北和东北地区。结论 全国14家三甲医院抗菌药物的用药趋势基本符合我国当前的用药趋势，但是在用药合理性上还是存在用药过于集中，抗菌药物使用频度和选药性价比不合理等问题。医院相关部门应建立完善抗菌药物临床应用管理长效工作机制，提高用药针对性，合理地干预，确保抗菌药物使用安全和合理。

Abstract:

OBJECTIVE To investigate and analyze the clinical use of antibiotics in 14 hospitals from 2014 to 2016. METHODS The use of antibiotics in 14 hospitals were investigated and analyzed, including antibiotic medication (DDDs), the average daily cost (DDC) index, the number ratio (B/A), strength (AUD) and outpatient prescription etc. RESULTS The sales amount, AUD, antibiotic usage frequency and sales ratio of antibiotics in 14 hospitals all over the country showed an increasing trend year by year during the period of 2014 to 2016. The top three of antibiotic sales were cephalosporins and penicillin antibiotics. In addition, the use of antibiotic injections was decreased year by year. According to ordinal ratio and DDC index analysis, the reasonable level of antibiotic price increased year by year in the past 3 years. In the 7 different regions of the country, the average amount of sales and utilization of antibiotics in 3 years was highest in East China, followed by North China and Northeast China. CONCLUSION The medication tendency of 14 hospitals is in accord with the trend of drug use of antibiotics in China, but in the rational use of drugs or medication is too concentrated, the problem of antibiotic use frequency and drug price. Hospital relates departments should establish and improve the long-term mechanism of antibiotic drug clinical application management, improve drug use targeted, reasonable intervention, and ensure the safe and rational use of antibiotic drugs.