Multiple Analysis Of Antimicrobial Use In A Third-Grade Hospital

Background and obejective:Because of the wide using of Antimicrobial drugs,the global bacterial drug resistance is gradually rising,which has became a threat public health problem to human health.And the irrational use problem is very prominent in our country.Including no pointer using,improper selection,high-dose medication for a long time,unreasonable combination,and so on.The reason mainly includes the relevant laws and regulations are not perfect in our country,the functional departments of the regulatory system is not sound,and the widespread phenomenon of drug-maintaining-medicine,the clinical medical staff have dependence on antibacterial drugs and and residents are short of the knowledge level of it.These reasons lead to drug control situation in our country is not optimistic.in order to further standardize the application of antimicrobial agents,reduce drug adverse reactions,curb the further development of drug-resistant bacteria.The used Ministry of Health carry out the clinical application and rectification activities of antibacterial drugs between 2011-2013 across the country.At the same time,according to the new problems,National health development planning commission revised and promulgatd<the antimicrobial clinical practice guidelines(2015 edition)>;For the rational use of antibiotics.Since 2015,several provinces and cities in our country promulgated local health department measures,which ruled that cancel outpatient transfusion,in order to achieve the purpose of inhibiting excessive use of antimicrobial drugs.At the same time,in August 2016,the national health and family planning commission joined 14 departments formulated the<"containing bacteria resistant national action plan(2016-2020)>.All these measures illustrated the government's determination and strength in antimicrobial use regulation.In this study,we research the antimicrobial drug use situation and existing problems,characteristics and developing trend of a hospital through year 2011 to 2016.at the same time,evaluate the effects of stopping outpatient infusion measures.Provide reality reference on the rational use of antimicrobial drugs for this hospital and standard management,and establishing relevant policies and regulations?guidelines for national standard.Method:The adoption review research method,collect the recipes of inpatient and out-patient department of this hospital from year 2011 to 2015 and analysis the indicators;collect the data before and after stopping outpatient infusion measures was carried out three months.statistical analysis the indicators of antibacterial agents.Results:1.The using status of antibacterial agents in outpatient:In 2011-2015 outpatient antimicrobial drugs utilization rate is 31.2%,higher than the provisions that the provisions of the antibacterial drugs using rate must lower than 20%,but the utilization rate showed a trend of decrease year by year;the constituent ratio of Antimicrobial drug use dosage form obviously have change,oral absorption is a rising trend,and injection is a decrease trend;Combination of the drugs is always falling,single use and the joint utilization rate decreased gradually.2.The using status of antibacterial agents in inpatient:In 2011-2015 inpatient antimicrobial drugs utilization rate is 47.9%,below the requirements that the antimicrobial agents utility ratio of hospitalized patients must less than 60%?But some department's antimicrobial drugs utilization rate is high,such as pediatrics,ICU and respiratory.antimicrobial agents make the proportion of 94.9%,94.83%and 92.7%respectively.Antimicrobial etiology inspection rate is generally low,unreasonable choosing drugs are widespread,in the same sort of antimicrobial drugs,doctors are more likely to choose the drugs which DDDC values is high,increased the burden of patients.3.The usage of antibacterial agents afer the cancel outpatient transfusionAfter this policy implementation,the ratio of outpatient clinic fall 3.82%year-on-year,antimicrobial drug consumption was down about8.55%,the ratio of antibacterial agents dropped 4.3%,injection of antimicrobial agents percentage of antibacterial agents down 10%.oral preparations of cefixime sales ranked first.The antimicrobial drug consumption amount of the surrounding communities has no significant changes.Conclusion:18 kinds of antimicrobial drugs was used in this hospital,among them,utilization of outpatients' antimicrobial prescription is 31.2%,antimicrobial drug use in hospitalized patients was 47.9%.New,high-grade antimicrobial drug use is given priority,mainly including carbapenems and beta-lactam antibiotic.Antimicrobial unreasonable using phenomenon is widespread,no pointer medication and preventive use clearly,drug use concentration,high price antibacterial drug use offen,low etiology detection and so on.After policyimplementation,The percentage of outpatient injection antibiotic drug usage has fallen by 10%,antibacterial drug consumption amount reached the lowest point in nearly six years at the same time,but still high?This policy executive strength is not enough at present,but the generally used medication is changing.In order to improve the existing situation,the relevant administrative departments should perfect the relevant laws and regulations further,supervision departments should perfect the supervision and management measures,to improve the clinical medicine knowledge level of medical staff further.Hospital should set up a perfect using standard of antimicrobial agents,set up rewards and punishment system,to make the measures carry out.Pharmaceutical department should strengthen the guidance and supervision of clinical drug use.clinical antibacterial drug knowledge training shoud carry out regularly,strengthening the construction of medical ethics.