Investigation And Analysis On The Situation Of Off-lable Use Of Antibacterial Agents In One Grade A Hospital Of Second Class

OBJECTIVE:To determine the extent of off-label drug use about antimicrobial drug in a dimethyl hospital and analyze its risk factors, so as to provide rational using measures for improving people’s understanding and promoting the rational use of antimicrobial drugs in hospital.METHODS:A retrospective survey method was used to searche to statistics the amount and off-label drug use of antimicrobial drug in2012. Random sampling was conducted to select medical advice. According to drug instructions, the off-label drug use of prescriptions was analyzed in the following aspects, the category of off-label drug use, gender, age, diagnosis, prescription and the ranks of doctors.Microsoft Excel2003,x2segmentation method and Logistic regression model were used to analyze.RESULTS:The hospital medicines purchased cost112.899million throughout the year of2012, in which antimicrobial drugs ranking first accounted for21.36%. The DDDs of Cephalosporins, quinolones, macrolides and penicillins accounted for79.54%, which were the main types of clinical using.The findings suggest that off-label drug use of antimicrobial drugs more common in the hospital, involving patients of different ages, different levels of physicians and clinical commonly used types of antibiotics. The off-label drug use was super-complex, some were rational use needed to regulate differentiated. Specific conditions are summarized as follows:Part I:Outpatient prescriptions. Outpatient antibiotic prescriptions were taken2640,3119prescription were analyzed involving89antibacterials items. The rate of off-label drug use was34.55%,33.57%,80.90%,according to the prescription, prescription and different drugs.The frequency of administration, dosage, indications for the main types of medication were the main style of off-label drug use. The off-label drug use had high incidence among infants, children, adolescents and cephalosporins, β-lactamase inhibitor compound, penicillins. The rate of off-label drug use was no significantly different among the different ranks of doctor. Part Ⅱ:medical records. The cases taken were2640and analyzed prescriptions were3572, involving80antibacterials items. The rate of off-label drug use was39.24%,29.48%,86.25%according to the cases, prescription and different drugs.The off-label drug use had high incidence among infants, children, adolescents and cephalosporins, β-lactamase inhibitor compound, macrolides. The rate of off-label drug use was different among the different ranks of doctor.CONCLUSION:1, The off-label drug use was complicated through the investigation of this subject, which should be treated differently.2, It was badly in need of developing relevant legislations, regulations or guidelines to regulate off-label drug use, in order to standardize clinical medicine and ensure the safety of pediatric drug use.3,There was no legal and strong measures to ensure drug instructions was scientific and authoritative, which was called on.4, This project can help the hospital pharmacy staff directly involved in clinical drug treatment work and enhance their value.