The Utilization Analysis Of Antimicrobial Agents In213A-grade General Hospitals From4Provinces

Objective:The usages of antimicrobial agents of inpatients of213A-grade general hospitals in four provinces were investigated to evaluate the indicators of the utilization of antimicrobial agents,understand the application of antibacterial agents, analyze the most commonly used antibiotics and the problems of their usage, to compare the differences of antibiotic usage situations between different provinces, to find the difference of the investigate result with the target value and to provide reference for the use of primary medical health institution. The ultimate goal is to analyze the application status of antibacterial agents from the Ministry of Public Health carrying out special management of the application of antimicrobials, to provide a reference to develope a criteria to promote the rational use of antimicrobial agents, to reduce antimicrobial drug abuse, to delay the produce of multi-resistant bacteria, to improve the level of anti-infection treatment and let the usage of antibacterial drugs more safe, effective and economic.Methods:The sampling objects are the discharged patients of213A-grade general hospitals from four provinces, Hebei, Henan, Shanxi and Shanxi.100cases from each hospital were randomly selected to investigate and analyze their antimicrobial usage, including the purpose of the antibiotic, the categories and varieties, the dosage and medication days of antibiotics. The average utilization rate of antibacterial agent, the average antibacterial use density, the detection rate of microorganism and the average number of antibiotics per patient were calculated according to The Principle of Antibacterial Application and Medical Quality Management and Control Index of Tertiary General Hospital. Appropriate forms were designed to collect the information of the patients and SPSS13.0and PEMS3.1statistical software were used to process data, with chi-square test to compare the difference between the usage of antimicrobial agents between the4provinces.Result:The average frequency of antibacterial agent use for2122cases of21 hospitals from four provinces is56.27%. The average antimicrobial agents utilization rate of Hebei, Henan, Shanxi and Shanxi are61.40%,50.33%,63.58%and52.25%respectively. The antibiotics usage rates of Hebei and Shanxi are higher than Henan and Shanxi with statistically significant differences. The average antibacterial use density of all the patients is35.7DDD and the antibacterial use density of Hebei, Henan, Shanxi and Shanxi are37.30,33.20,40.80and32.27respectively. The microbiological tests rate of the patients used antibiotics to treat the infection is52.31%. The21hospitals have used18categories of antimicrobial agents with81product varieties, of which,27belong to Cephalosporin,9belong to Penicillins and6belong to Quinolones. Be evaluated by the drug daily dosage, the most widely used antimicrobial agents are the third generation cephalosporin, the second generation cephalosporin and quinolones, and the DDDs are1940,1629and1142respectively. The patients use1.48kinds of antimicrobial agents personally. The average days of antibiotic medication is7.48days, and the longest is10.76days, the shortest is5.0days. The proportion of the patients given intravenous antibiotics and oral antibacterial are95.14percent and2.68percent.Conclusion:According to the survey, all of the hospitals have pharmacy administration committee, drug list and medication guidelines. The average rate of antibacterial agent usage, the antibacterial use density and the detection rate of microorganism have been suit to the requirements of the Ministry of Health, and the measures taken in our country to strengthen the management of antimicrobial agents show an effect. But there are still some problems in a few hospitals, such as the utilization rate of antibiotics is so high, with low etiology inspection rate, and the most frequently used categories of antimicrobial agents are third generation cephalosporin and quinolone. The most commonly used antimicrobial agents are Levofloxacin, Cefuroxime and Ceftriaxone. The proportion of the patients given antibiotics for injection is above90percent.