| Objective Through the analysis of the usage rate of antibacterial drugs,the time per person used,the frequency of use of antibiotics(total DDDs),total antimicrobial use intensity),the classification and grade of use of(AUD),antibacterial drugs in the hospitalized newborns from 2015 to 2018 in our hospital were analyzed.In order to provide important and objective data for further understanding the current situation of neonatal antibacterial drug use in China,we have a comprehensive understanding of the use of antibacterial drugs in newborns in our hospital.Methods The subjects of the survey were newborn subjects in Chenzhou Hospital Affiliated to Nanhua University(including general ward,premature infant ward,NICU)from January 1,2015 to December 31,2018).The related data of all hospitalized newborns from 2015 to 2018,including the number of hospitalized infants,the number of cases of antimicrobial use,the classification and grade of use of total DDDs,AUD,antibiotics,were statistically analyzed by using the Hospital Information system(HIS).Results 1.Over all use of antibiotics during the period from 2015 to 2018,the average use time per capita showed a declining trend,there was a significant decline in 2017,the total DDDs,AUD in 2015 and 2016 was basically unchanged,and in 2017,there was a significant decrease in 2018.There was a significant difference in the usage rate of antibiotics between 2015 and 2018(P< 0.01).There was a significant difference in the usage rate of antibiotics between the first two years and the later two years(P < 0.05).2.The AUD of different types antibiotics from 2015 to 2018.The top five AUD of antibacterial drugs in 2015,2017 and 2018 are: penicillins,cephalosporins,antifungals,carbapenems,macrolides.In the year of 2016,the top five AUD of antibacterial drugs are:penicillins,cephalosporins,antifungals,carbapenems,glycopeptides.3.Top 10 AUD of major antibacterial drugs in 2015-2018.The top 10 AUD of antibacterial drugs are roughly the same from 2015 to 2018,including: ampicillin sulbactam sodium,fluconazole,ceftazidime,amoxicillin clavulanic acid Potassium,piperacillin tazobactam,ceftriaxone sodium,cefotaxime,penicillin,piperacillin sodium,cefepime,meropenem.4.AUD of different grades of antibacterial drugs from 2015 to 2018.Non-restricted,restricted,special grade antibacterial drugs AUD and proportionsare11.18(32.01%),22.69(64.99%),1.05(3.00%)in2015;10.94(31.14%),22.93(65.27%),1.26(3.59%)in2016;7.09(23.79%),21.52(72.21%),1.19(4.00%)in2017;6.52(22.90%),20.81(73.10%),1.12(4.00%)in 2018.5.AUD of different grades of antibacterial drugs in very low and ultra low birth weight infants from 2015 to 2018.Non-restricted,restricted,special grade AUD and proportions were 12.93(73.89%),1.88(10.74%),2.69(15.37%)in 2015;respectively,12.56(71.85%),1.81(10.35%),3.03(17.80%)in2016;9.56(64.86%),1.21(8.21%),3.97(26.93%)in2017;9.04(63.89%),2.16(15.27%),2.95(20.84%)in2018.6.The use of antibacterial drugs alone and in combination from 2015 to 2018.The proportion of antibacterial drugs used in 2017 and 2018 are slightly higher than that in the previous two years.The proportion of the second-line combination is totally the same,and the proportion of triple-linking shows a downward trend.There were significant differences in the proportion of single-use antibiotics,triple and above in the period from 2015 to 2018(P <0.01).There was no significant difference in the proportion of antibiotics(P > 0.05).The proportion of single use of antibiotics during the period from 2015 to 2018 was slightly higher than that of the previous two years,but the ratio of the two drugs did not change much,but the proportion of the triple drug showed a decreasing trend as a whole,and the proportion of single use of antibiotics from 2015 to 2018 was slightly higher than that of the previous period,and the proportion of single use of the antibiotics from 2015 to 2018 showed a trend of decline.There was a significant difference in the proportion of triplet and above(P < 0.01).There was no significant difference in the ratio of two couplets(P > 0.05).7.The progress of bacterial culture and the cultivation of common multi-drug resistant strains from 2015 to 2018.In 2015,9 cases of MRSA,31 cases of ESBLs,2 cases of carbapenem resistance;1 case of VRE,12 cases of MRSA,33 cases of ESBLs and 1 case of carbapenem resistance were found in bacteria culture and common multi-drug resistance in 2016.In 2017,there were 15 cases of MRSA,36 cases of ESBLs,3 cases of carbapenem resistance;6 cases of MRSA,31 cases of ESBLs and 3 cases of carbapenem resistance in 2018.The positive rate of bacterial culture and the positive rate of multi-drug-resistant bacteria in the four-year period from 2015 to 2018 showed no difference.Statistical significance(P > 0.05).Conclusion1.During the period from 2015 to 2018,the overall use of antibiotics in neonates in our hospital tended to be reasonable.The usage rate of antibiotics,total DDDs and AUD decreased gradually,and the single and combined use of antibiotics improved further.2.The level of use of antibiotics and the proportion of combined use of antibiotics in neonates in our hospital are still on the high side.Attention should be paid to it,and supervision and guidance on rational use of antibiotics should be strengthened. |
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