Practice Research On Antibacterial Drugs Clinical Application Management In A Large Comprehensive Tertiary Hospital

Objective The rational use of antibacterial drugs in hospitals is the key to reduce bacterial resistance.In China,the clinical application level of antibacterial drugs has gotten obvious improvements.However,there are still some indicators of antibacterial drugs clinical application management in some hospitals that do not reach the targets.Some doctors have bad habits in selecting antibiotics,some rules are not strict to carry out,trainings and examinations lack pertinence.If these problems are not solved thoroughly,sustainable management will fail.The author had taken part in the practice of clinical application management of antibacterial drugs in the medicine department of a hospital.The author tried to grasp the key joints,optimized the key indicators,and established a sustainable management system.Methods This study set up management organization system of antimicrobial drugs in the hospital,specified functions on antibacterials management of every department,emphasized the pressure conduction of management,and discussed the selection method of antibacterials catalog.The result of the study pointed out that pharmacy department cannot independently complete the task of antibacterials application management.Thus a comprehensive evaluation system has been established,which includes organizational leadership,regulations and practices,training results,informatization level,infection control in the hospital and postoperative,clinical nursing skill level,pathogen detection,and surveillance of drug resistant bacteria.The responsibilities have been clearly divided by the evaluation system.Two software systems have been developed,one named antibacterial drugs surveillance system, another for on-line hospital consultation of special use grade antibacterials.Experts from clinical,pharmacy,hospital infection management and microorganism wrote two manuals,respectively named “Handbook of rational use of antibacterials in hospital” and “examination syllabus for rational application of antibacterials”.Results The optimization of hospital's antibacterial drugs catalog had been gradually realized.The on-line consultation of special use grade antibacterials caused dramatic promotion of the efficiency.All kinds of indicators were close to reality and reached the standard.In the first quarter of 2018,the usage rate of antibacterial drugs was 35.2%,and the use intensity of antibacterials had decreased to 39.9 DDD.Meanwhile the bacterial examination rate for therapeutic antibacterials had increased to 56.7%.Conclusion The study summarized the achievements and measures of antibacterials application management,from the aspects of organization and management,index decomposition,information technology application,training and test,pathogenic detection,bacterial resistance surveillance,etc.The research analyzed indicators including use intensity of antibacterials,the antibacterial prevention rate in type I incision,etc.Among them,clinical department level indicators especially had practical value,and they were based on the diagnosis and disease characteristics.The optimum design of hospital's antibacterial drugs catalog was effective.The software for on-line consultation of special use grade antibacterials won the praise of other hospital pharmacy experts.Strict tests improved the level of amtibacterials use of doctors.