谢敬丹,郭宇姝,游亮,王静.门诊抗菌药物处方不合理应用干预研究[J].转化医学杂志,2019,8(6):353-355
门诊抗菌药物处方不合理应用干预研究
Intervention study on unreasonable use of antibiotic on outpatient clinic
  
DOI:
中文关键词:  合理用药  抗菌药物  处方干预  门诊
英文关键词:Rational drug use  Antimicrobial drugs  Prescription intervention  Outpatient clinic
基金项目:院内创新培育基金项目(CXPY201513)
作者单位
谢敬丹 北京中国人民解放军总医院第六医学中心药剂科 
郭宇姝 北京中国人民解放军总医院第六医学中心药剂科 
游亮 北京中国人民解放军总医院第六医学中心药剂科 
王静 北京中国人民解放军总医院第六医学中心药剂科 
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中文摘要:
      目的 分析药师对门诊抗菌药物处方合理应用的干预作用,提高细菌性感染的抗菌治疗水平,保障患者用药安全及减少细菌耐药性。方法 随机抽取中国人民解放军总医院第六医学中心门诊2017年11月1日—2018年3月31日抗菌药物处方作为对照组(干预前),另抽取2018年6月1日—2018年10月30日抗菌药物处方作为观察组(干预后)。每月抽取1 500张,两组各7 500张。对抗菌药物干预前后的使用率、不合理处方数以及不合理处方主要存在问题进行分析。结果 与干预前比较,干预后门诊抗菌药物的使用率由12.18%下降到8.23%(χ2=2 785.244、P=0.000);不合理处方比例由56.53‰下降到16.13‰(χ2=174.81、P=0.000)。不合理应用抗菌药物的处方主要问题为不规范处方、用药与诊断不符、遴选药物不适宜、给药途径不适宜、用法用量不适宜、药物相互作用,干预后与干预前比较,差异比较均有统计学意义(χ2分别为10.30、29.57、12.77、9.16、102.74、9.32,P分别为0.001、0.000、0.000、0.002、0.000、0.002)。结论 药师干预后,抗菌药物的使用率、不合理处方率有明显下降趋势。医生能安全、有效、合理应用抗菌药物,体现了药师干预在合理应用抗菌药物中的积极作用。
英文摘要:
      Objective To analyze the intervention effect of pharmacists on rational application of antibiotics prescription in out patient clinic, to improve the level of antibacterial treatment for bacterial infection,to ensure patient safety and reduce bacterial resistance. Methods The antibacterial prescriptions of our outpatient clinic from November 1, 2017 to March 31, 2018 were randomly selected as the control group (before the intervention). The antibacterial prescriptions from June 1, 2018 to October 30, 2018 were selected as the observation group (after the intervention). Take out 1 500 pieces per month, 7 500 pieces in each group. Chi-square test was carried out on the usage of antibacterial drugs, unreasonable prescription number and main problems of irrational prescriptions before and after the intervention. Results Before and after intervention, the use rate of antibacterial drugs on outpatients decreased from 12.18% to 8.23% (χ2=2 785.24, P=0.000). The rate of unreasonable prescription decreased from 56.53‰ to 16.13‰ (χ2=174.81、P=0.000). The main problems in the prescription of unreasonable use of antibacterial drugs are irregular prescription, medication inconsistent with diagnosis, inappropriate selection of drugs, inappropriate route of administration, inappropriate use and dosage, and regardless of the drug interaction. The difference was statistically significant before and after intervention (χ2=10.30, 29.57, 12.77, 9.16, 102.74, 9.32; P=0.001, 0.000, 0.000, 0.002, 0.000, 0.002). Conclusion After the intervention of the pharmacist, the usage of antibiotics and unreasonable prescription have significant decline trend. Doctors can safely, effectively and rationally use antibacterial drugs. It represents the positive role of pharmacist intervention in reasonable application of antibacterial medicine.
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