Investigation Of Usage Of Antimicrobials In Emergency Medicine Of The Tianjin Fifth Center Hospital

Objective:To understand the situation of use of antibiotics in the emergency internal medicine of Tianjin Fifth Central Hospital, through the analysis of its characteristics, provides the theory basis for reasonable antimicrobial agents, regulate the usage of emergency patients.Methods:From2011November to2011December using the emergency inter nal medicine of Tianjin Fifth Central Hospital admissions of antibacterial drugs (including all adult patients admitted to emergency ICU patients) were6384c ases, according to the age group of statistics, record the patient’s sex, age, und erlying diseases, testing, inspection, a preliminary diagnosis, using specific anti microbial agents, antimicrobial and combination of two ways, using dose and patient outcome data, will be incorporated into the data according to the age t o ten years of age the age were divided into9groups, analysis of the use of patient age and sex distribution rate, the situation of antibiotics; antibiotic use in patients with disease and fever of various statistics system infection, to inv estigate the antibacterial drugs use and unreasonable use the antibacterial drugs, respectively, elderly patients(≥60years)and non elderly patients(<60years)usin g characteristics between the generations, cephalosporin usage compared to use of antimicrobial drugs commonly used; based on the laboratory tests(includin g white blood cells, neutrophils, C reactive protein, serum procalcitonin etc.),an alysis and Study on the training examination and bacteriological imaging, in-de pth study of the level of emergency physicians use Antimicrobial and differenc e. Data using SPSS16.0statistical software for statistical processing statistical p rocessing.Results:①The:emergency patients, antimicrobial drug use was49.9%,the old est96years old, the youngest14years old, mean age39.5±2.03years, of which20to59years for the emergency antibacterial concentration group, a to tal of4438cases, accounting for69.6%of the total cases. Relatively few belo w20years old and90years old age group the number of cases, a total of406cases, accounting for only6.4%of the total cases.20-29years old were1544cases in all cases accounted for the largest proportion, about24.2%; followed by30～39years old group, a total of1371cases, accounting for21.5%of th e total cases;40～49years old group ranked third, a total of816cases, accoun ting for12.8%of the total cases.6384cases were male2850cases, female3534cases, male and female ratio of0.81:1.②The use of antibacterial drugs in eme rgency internal medicine disease proportion were infection, urinary system infecti ons of the digestive system and respiratory system infection, accounted for65.07%,22.08%,3.33%, and the respiratory system infection accounted for absolute a dvantage.③The emergency of elderly patients(≥60years) and non elderly patien ts have no basis in history, use the higher level of antimicrobial drugs, drug combi nation and hospitalization differences were significant (P<0.01).④The emergenc y internal medicine antimicrobial use drugs before three for azithromycin in1814cases, accounting for25.41%,1226cases of clindamycin, accounted for17.17%, levofloxacin1198Cases, accounted for16.78%, the emergency of antibiotics in cephalosporin use rate of27.96%, the use of two generation cephalosporins are as follows:the highest utilization rate,67.43%, followed by three generations of cephalosporins, accounted for30.42%, accounted for only2.15%of generation.⑤Use of antibiotics in emergency patients by t test can be seen the indication o f application of P<0.01, has obvious indications of drug use, no indication is als o statistically significantly, belong to no basis for the use of(P<0.01). Emergenc y patients used mostly in patients with fever of antibacterial drugs in3991case s, fever in3774cases, use of antibiotics, the use rate of94.56%, including3512cases of syndrome refers to use, no262cases of inger syndrome, accounted for93.06%and6.94%. According to the bacteriological examination, the main pathog enic bacteria in our hospital emergency internal medicine were Pseudomonas aer uginosa (42cases),Klebsiella pneumonia (28cases), Escherichia coli (24cases), B auman Acinetobacter (20cases), accounted for16.9%,11.9%,10.2%,8.4%; drug sensitivity tests showed cephalosporin class to the pathogens sensitivity were Esch erichia coli, Bauman does not move bacillus, Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus epidermidis; quinolones were Pseudomonas aerugi nosa, Klebsiella pneumoniae, Escherichia coli,Staphylococcus epidermidis, Bauma n Acinetobacter; aminoglycosides.:Pseudomonas aeruginosa, Klebsiella pneumonia e, Escherichia coli,Staphylococcus epidermis and Bauman acinetobacter. Antimicrobi al unreasonable situation including the use of inappropriate varieties in20cases,a ccounting for4.12%, unnecessary or unreasonable drug combination in122case s, accounting for25.15%, large dose of users in77cases, accounting for15.88%, usage and dosage is not reasonable in98cases, accounting for20.20%, freq uent change in53cases, accounting for10.93%, selection of solvent is not reaso nable in90cases, accounting for18.55%,25cases of long-term drug users, acco unting for5.15%.⑥The emergency physician, all levels of TCM physician, associ ate chief physician, director of administration without indication were281case s,139cases,49cases,16cases, accounted for57.93%,28.67%,10.10%,3.30%. A ntibiotic use and level, level:doctors antibiotics were used in2771cases, accounti ng for49.56%, attending physicians were used in2227cases, accounting for39.83%, deputy chief physician487cases, accounting for8.71%,106cases, accounte d for1.89%;two:doctors antibiotics were used in689cases, accounted for44.51%,attending to566cases, accounting for36.56%, deputy chief physician used in217cases, accounting for14.02%, chief physician76cases, accounted for4.91%; all levels of doctors to use antibiotic difference at all levels was statistically significant (P<0.01)..Conclusions:1antibacterial drugs are the emergency department patients infec ted with the most widely used drugs, which is not affected by gender and age, m ainly concentrated in the20-60years old.2emergency use of antimicrobial age nts were still mainly in the respiratory system disease, digestive, urinary system i nfection, especially in the respiratory system disease.3emergency patients with in travenous administration of antibacterial drugs, but there is the improper selection of antibiotics, usage, dosage is not reasonable, and the combined application of antibiotics is not sufficient evidence, the irrational use of antimicrobial drugs. Rat e, use of high level of antimicrobial drugs and combined use of antibacterials sig nificantly more than other age groups of patients hospitalized elderly patients4e mergency department visits.5emergency patients use of antibiotics based mainly on white blood cell, neutrophil, serum C-reactive protein and procalcitonin, ur ine routine and the imaging findings, bacterial culture very little;6by bacterial c ulture, drug sensitive test of bacteria examination can effectively guide the clinic alreasonable application of antibiotics. Antimicrobial agents, rational use of standa rd7high seniority doctors.