Analysis Of The Rational Use Of Antimicrobial Drugs In A Large Comprehensive Tertiary Hospital

Along with the popularization and widespread use, antimicrobial drugs have become the most common-used kind of drugs. At the same time, however, abuse and other unrational use of these drugs resulted in untoward drug effect and drug resistance, which gradually constitute a serious problem to medical treatment and our society. To standardize the rational use of antimicrobial drugs and decrease the untoward effect, our country issued "The Guiding Principle on the Clinical Use of Antimicrobial Drugs", which made out standard directions to clinical problems about antimicrobial drugs such as when to use, how to select the kind and what administration scheme should be taken. The principle is both fundamental and practical.To imprive their quality of medical treatment, standardize the clinical use of antimicrobial drugs, reduce the costs of medicine, slow down the emergence and expansion of drug-resistance, serve the patients by providing them the drugs in a safe, effective and economical way, a large comprehensive tertiary hospital, in accordance with the demand of the principle guideline, work out its own "Guiding Principle on the Rational Use of Antimicrobial Drugs", Classified Management of Antimicrobial Drugs, Regulation on Clinical Use of Antimicrobial Drugs, detailed rules and regulations on local, preventive and aronud-operation use of the drugs, and specific evaluation criterion on drug selection, combinational-use of the drugs, pharmacodynamics and pharmacokinetics indexes. It was demanded to restrict the drug-selection criterion, strengthen pathogen detection and drug-sensitivity test, enhance clinical use and ADR monitoring. The hospital take the lead to enforce clinical supervision and instruction on use of the drugs, thus evaluate the condition of antimicrobial drugs. These measures promoted the rational use of the drugs. From the year of 2006 to 2009, the rate of specimen summision and culture in ward increased year by uear, the coincidance rate of antimicrobial drugs to pathogenic microbials reached 96.6%, the appearance rate of antimicrobial drugs in outpatient department was decreased to 18.7% in 2009 compared to 36.2% in 2006. The abuse of antimicrobial drugs was preliminarily suppressed. Clinical supervision and instrution model of rational use of antimicrobial drugs was continuously perfected. The role of clinical pharmacist in infection management was greatly reinforced. Clinical pharmacist came to wards to inspect patients relevant to infective diseases, took part in clinical group consultation of serious infection. The emergence and expansion of drug-resistance bacterial strain was retarded, in-hospital infection decreased, in-ward period shortened and medical costs depressed. These mearures also help to solve the difficuty in seeking medical service, put an end to bad voque in medicine buying and selling, suit the demand of medical treatment and hygiene system renovation, township medical insurance and new countryside medical-coorperation system.We come to the conclusion that:1. Resolutely implementation of "Guiding principle on the clinical use of antimicrobial drugs" is a necessary measure in our country to avoid irrational use of antimicrobial drugs and decrease adverse drug reaction."2. Successful implementation of the "Guiding principle" relied on strong organization and leadership, rigorous and detailed execution procedure and strict supervision system. Medical and pharmaceutical staff should consolidate the knowledge and consciousness of rational drug use and improve their ability of speciality.3. Serious implementation of the "Guiding principle" lead to improvement of consciousness to rational drug use, increases in specimen submission rate, diagnosis coincidence rate, correctness rate in drug use, and decreases in the abusement and other irrational use of antimicrobial drugs.