Analysis of antibiotic use in clinical departments of a hospital
-
摘要:
目的 调查和分析某院住院患者抗菌药物使用基本情况，以期发现抗菌药物使用的一般规律和问题，规范临床合理使用抗菌药物，保障患者合理用药。 方法 收集某院2019—2023年全院各临床科室的住院患者抗菌药物消耗量和同期的出院患者平均住院时间（d）以及所有的出院患者人数，计算住院患者的抗菌药物使用强度和抗菌药物使用率，并对各个科室和各个抗菌药物的使用强度进行统计分析和排名。 结果 住院患者总体的抗菌药物使用率为42.99%，其中排名前五的科室分别为急诊外科（90.38%）、泌尿外科（87.66%）、耳鼻喉科（86.57%）、妇科（85.53%）和ICU（85.45%），排名倒数前三的科室为肿瘤外科（8.72%）、肿瘤内科（7.16%）和眼科（5.59%）；住院患者总体的抗菌药物使用强度为45.38，其中排名前五的科室为ICU（216.41）、急诊外科（211.77）、急诊内科（137.05）、小儿内科（97.35）和血液科（97.30），使用强度排名倒数前三的科室为康复医学科（7.41）、肿瘤内科（7.26）和眼科（5.07）；使用强度排名前五的抗菌药物依次为左氧氟沙星（7.29）、头孢地嗪钠（6.63）、头孢呋辛钠（3.43）、注射用头孢硫脒（2.51）和注射用头孢哌酮钠舒巴坦钠（2.35），使用强度排名倒数的3个药品为注射用阿奇霉素（0.77）、注射用头孢西丁钠（0.72）和注射用头孢唑林钠（0.66）。 结论 某院抗菌药物使用强度过高，需加大抗菌药物管理力度，促进抗菌药物合理使用。 Abstract:Objective To investigate and analyze the basic situation of antimicrobial use among inpatients in a hospital, with the aim of identifying the general patterns and issues related to antimicrobial usage, promoting standardized and rational antimicrobial use in clinical settings, and ensuring patients medication safety. Methods Data on antimicrobial consumption among inpatients in various clinical departments in the hospital from 2019 to 2023 were collected. The average length of hospital stay (days) and the total number of discharged patients during the same period were obtained. The antimicrobial use density (AUD) and antimicrobial usage rate (AUR) among inpatients were calculated. Statistical analysis was conducted to rank each department and each antimicrobial agent according to their AUD values. Results The overall AUR among inpatients was 42.99%. The five departments with the highest AUR were Emergency Surgery (90.38%), Urology (87.66%), Otorhinolaryngology (86.57%), Gynecology (85.53%), and ICU (85.45%). The three departments with the lowest AUR were Oncology Surgery (8.72%), Oncology Medicine (7.16%), and Ophthalmology (5.59%). The overall AUD among inpatients was 45.38. The five departments with the highest AUD were the ICU (216.41), Emergency Surgery (211.77), Emergency Medicine (137.05), Pediatrics (97.35), and Hematology (97.30). The three departments with the lowest AUD were Rehabilitation Medicine (7.41), Oncology Medicine (7.26), and Ophthalmology (5.07). The five antimicrobial agents with the highest AUD were levofloxacin (7.29), cefodizime (6.63), cefuroxime (3.43), cefathiamidine for injection (2.51), and cefoperazone sodium and sulbactam sodium for injection (2.35). The three agents with the lowest AUD were azithromycin for injection (0.77), cefoxitin sodium for injection (0.72), and cefazolin sodium for injection (0.66). Conclusion The AUD is excessively high in this hospital, indicating the need to further strengthen antimicrobial management to promote the rational use of antibiotics. -
Key words:
- Antibacterial agents /
- Antibiotics use density /
- Rational use
-
表 1 某院各临床科室抗菌药物使用率分布情况(%)
Table 1. Distribution of antibiotics usage rate in clinical departments of the hospital(%)
科室 抗菌药物使用率(使用抗菌药物人次/总人次) 科室 抗菌药物使用率(使用抗菌药物人次/总人次) 科室 抗菌药物使用率(使用抗菌药物人次/总人次) 急诊外 90.38(2 799/3 097) 胸外 57.27(1 785/3 117) 妇瘤 37.36(2 580/6 905) 泌尿外 87.66(2 231/2 545) 感染 55.28(1 413/2 556) 康复医学科 30.85(87/282) 耳鼻喉 86.57(4 410/5 094) 疼痛 53.74(115/214) 消化 26.51(826/3 116) 妇科 85.53(3 068/3 587) 肾病科 48.68(974/2 001) 放疗 25.28(1 099/4 347) ICU 85.45(423/495) 神外 48.29(750/1 553) 老年病 24.16(329/1 362) 小儿内 78.37(6 875/8 773) 普外四 47.04(597/1 269) 心血管 22.77(1 389/6 100) 整形 76.53(626/818) 呼吸 46.53(2 045/4 395) 神内 21.18(720/3 399) 口腔 74.16(1 785/2 407) 风湿免疫科 46.04(867/1 883) 内分泌科 17.82(337/1 891) 骨科 73.37(5 329/7 263) 胃肠外 45.48(1 424/3 131) 血管外 16.01(217/1 355) 产科 70.11(1 464/2 088) 血液科 44.57(944/2 118) 介入科 9.13(102/1 117) 心脏外 67.89(516/760) 全科 44.42(211/475) 肿瘤外 8.72(1 620/18 575) 急诊内 65.75(1 361/2 070) 肝胆 38.36(923/2 406) 肿瘤内 7.16(1 235/17 247) 皮肤性病科 58.19(167/287) 中医科 38.02(119/313) 眼科 5.59(236/4 225) 
下载: 导出CSV
表 2 全院各临床科室抗菌药物使用强度分布情况
Table 2. Distribution of antibiotics use intensity in clinical departments of the hospital
科室 抗菌药物使用强度(DDDs) 科室 抗菌药物使用强度(DDDs) 科室 抗菌药物使用强度(DDDs) ICU 216.41 全科 50.60 妇科 25.19 急诊外 211.77 皮肤性病科 49.85 产科 24.47 急诊内 137.05 神外 48.15 内分泌科 24.07 小儿内 97.35 老年病 46.45 中医科 19.54 血液科 97.30 胃肠外 45.99 疼痛 19.34 耳鼻喉 85.00 心脏外 45.00 肿瘤外 17.62 整形 83.77 口腔 42.92 血管外 16.23 感染 80.06 肾病科 39.95 妇瘤 13.74 呼吸 77.86 风湿免疫科 35.84 放疗 8.20 泌尿外 68.96 肝胆 33.26 介入科 7.94 普外四 59.97 神内 32.35 康复医学科 7.41 胸外 51.99 消化 28.69 肿瘤内 7.26 骨科 50.65 心血管 25.59 眼科 5.07
下载: 导出CSV
表 3 抗菌药物使用强度排名前20位的药品分布
Table 3. Distribution of top 20 drugs in terms of antibacterial drug use intensity
药品名称 使用强度(DDDs) 排名 药品名称 使用强度(DDDs) 排名 盐酸左氧氟沙星氯化钠注射液 7.29 1 盐酸莫西沙星氯化钠注射液 1.57 11 注射用头孢地嗪钠 6.63 2 注射用盐酸头孢替安 1.29 12 注射用头孢呋辛钠 3.43 3 注射用盐酸头孢替安 1.29 13 注射用头孢硫脒 2.51 4 硫酸庆大霉素注射液 1.01 14 注射用头孢哌酮钠舒巴坦钠(进口) 2.35 5 注射用头孢曲松钠 0.98 15 注射用哌拉西林钠舒巴坦钠(4∶1) 2.29 6 盐酸左氧氟沙星注射液 0.92 16 奥硝唑氯化钠注射液 2.20 7 注射用哌拉西林钠舒巴坦钠 0.90 17 注射用美罗培南 1.84 8 注射用阿奇霉素 0.77 18 注射用美洛西林钠 1.64 9 注射用头孢西丁钠 0.72 19 头孢地尼胶囊 1.64 10 注射用头孢唑林钠 0.66 20
下载: 导出CSV
-
[1] THEODOSIOU A A, JONES C E, READ R C, et al. Microbiotoxicity: antibiotic usage and its unintended harm to the microbiome[J]. Curr Opin Infect Dis, 2023, 36(5): 371-378. doi: 10.1097/QCO.0000000000000945 [2] 王雪, 汪雨贺, 高山, 等. 某三级教学医院呼吸重症病房抗菌药物管理核查表的临床应用及评价[J]. 中华全科医学, 2022, 20(10): 1792-1796. doi: 10.16766/j.cnki.issn.1674-4152.002704WANG X, WANG Y H, GAO S, et al. Evaluation and implementation of an antimicrobial stewardship checklist in a respiratory ICU ward in a tertiary teaching hospital[J]. Chinese Journal of General Practice, 2022, 20(10): 1792-1796. doi: 10.16766/j.cnki.issn.1674-4152.002704 [3] AGARWAL M, ESTRADA L V, GRACNER T, et al. Nursing home antibiotic stewardship policy and antibiotics use: 2013—2017[J]. J Am Med Dir Assoc, 2022, 23(3), 482-487. doi: 10.1016/j.jamda.2021.06.031 [4] CHEN B, YANG X, ZHAN M M, et al. Dietary tangeretin improved antibiotic-associated diarrhea in mice by enhancing the intestinal barrier function, regulating the gut microbiota, and metabolic homeostasis[J]. Food Funct, 2023, 14(24): 10731-10746. doi: 10.1039/D3FO02998K [5] SPEROTTO F, FRANCE K, GOBBO M, et al. Antibiotic prophylaxis and infective endocarditis incidence following invasive dental procedures: a systematic review and meta-analysis[J]. JAMA Cardiol, 2024, 9(7): 599-610. doi: 10.1001/jamacardio.2024.0873 [6] DING G D, ZHANG X B, VINTURACHE A, et al. Challenges in the treatment of pediatric Mycoplasma pneumoniae pneumonia[J]. Eur J Pediatr, 2024, 183(7): 3001-3011. doi: 10.1007/s00431-024-05519-1 [7] MCCANN P, KRUOCH Z, LOPEZ S, et al. Interventions for dry eye: an overview of systematic reviews[J]. JAMA Ophthalmol, 2024, 142(1): 58-74. doi: 10.1001/jamaophthalmol.2023.5751 [8] RAJAN S M, SHRESTHA B, AATI S, et al. Evaluation of antibacterial efficacy of high-intensity focused ultrasound versus photodynamic therapy against enterococcus faecalis-infected root canals[J]. Ultrasound Med Biol, 2023, 49(8): 1875-1881. doi: 10.1016/j.ultrasmedbio.2023.04.018 [9] FAN L, YANG M, HAN Y T, et al. Drug recommendation for optimization on treatment outcome for MDR/RR-TB based on a multi-center, large scale, retrospective cohort study in China[J]. Expert Rev Anti Infect Ther, 2024, 22(5): 353-363. doi: 10.1080/14787210.2024.2303032 [10] ECKMANN C, AGHDASSI S J S, BRINKMANN A, et al. Perioperative antibiotic prophylaxis-indications and modalities for the prevention of postoperative wound infection[J]. Dtsch Arztebl Int, 2024, 121(7): 233-242. [11] 窦欲晓, 胡学锋, 许健. 某综合医院神经外科围手术期抗菌药物合理性分析[J]. 中华全科医学, 2023, 21(10): 1686-1688. doi: 10.16766/j.cnki.issn.1674-4152.003201DOU Y X, HU X F, XU J. Rationality analysis of perioperative antibiotics in neurosurgery of a general hospital[J]. Chinese Journal of General Practice, 2023, 21(10): 1686-1688. doi: 10.16766/j.cnki.issn.1674-4152.003201 [12] LIEU A C, JUN J H, AFSHARI N A. Intracameral antibiotics during cataract surgery: efficacy, safety, and cost-benefit considerations[J]. Curr Opin Ophthalmol, 2024, 35(1): 50-56. doi: 10.1097/ICU.0000000000001010 [13] LIN M M, YANG S S, HUANG Q Y, et al. Effect and mechanism of Qingre Huashi decoction on drug-resistant Helicobacter pylori[J]. World J Gastroenterol, 2024, 30(24): 3086-3105. doi: 10.3748/wjg.v30.i24.3086 [14] GROENEN H, BONTEKONING N, JALALZADEH H, et al. Incisional wound irrigation for the prevention of surgical site infection: a systematic review and network meta-analysis[J]. JAMA Surg, 2024, 159(7): 792-800. doi: 10.1001/jamasurg.2024.0775 [15] ZAGALES I, SAUDER M, SELVAKUMAR S, et al. Comparing outcomes of appendectomy versus non-operative antibiotic therapy for acute appendicitis: a systematic review and meta-analysis of randomized clinical trials[J]. Am Surg, 2023, 89(6): 2644-2655. doi: 10.1177/00031348221114045 [16] HARTOFILIS L, RIGGINS J K. Abdominal pain: update on emergency department management of appendicitis and diverticulitis[J]. Emerg Med Pract, 2024, 26(10): 1-28.
点击查看大图
表(3)
计量
- 文章访问数: 10
- HTML全文浏览量: 4
- PDF下载量: 3
- 被引次数: 0
