【摘要】 目的调查与分析临床抗菌药物的使用情况,研究持续干预措施对抗菌药物合理使用及医院感染预防与控制的效果,为合理使用抗菌药物及预防医院感染提供指导依据。方法根据2006年监测结果,自2007年开始进行综合干预措施,医院感染办每季度抽查1个月的出院病例,药剂科每月通过监测软件进行抗菌药物使用种类的排名。结果通过5年持续干预措施的落实,不断持续改进,使医院抗菌药物使用率逐年下降,由2006年的69.4%降至2010年的62.21%;单一用药比例由2006年88.6%提高至2010年94.15%;抗菌药物使用量排名头孢哌酮/舒巴坦由2007年排名第1降至2010年第4位,医院感染率由2006年3.08%降至2010年的2.07%;医院感染漏报率由2006年15.5%降至2010年的1.63%;治疗性用药病原学送检率由2006年34.20%提高至2010年59.22%。结论多部门联合管理,综合性监测与目标性监测相结合,根据监测中存在的问题,反复多次突出重点的强化培训,多渠道持续干预是规范抗菌药物合理使用和医院感染预防与控制的综合手段。更多还原

【Abstract】 OBJECTIVE To investigate and analyze the use of clinical antibiotics,research the effect of continuous interventions on the reasonable use of antibiotics and the prevention and control of nosocomial infections so as to provide guidance for rational administration of antibiotics.METHODS Comprehensive monitoring was conducted for the combination of objective monitoring,according to the monitoring results of 2006,the comprehensive interventions started in 2007,the hospital infection control department reviewed quarterly the patients discharged within one month,the ranking of the antibiotics used was determined monthly by the pharmacy department.RESULTS Through five years of intervention our implementation antimicrobial usage declined year by year,decreasing from 69.4% in 2006 to 62.21% in 2010,single drug use proportion increased from 88.6% in 2006 to 94.15% in 2010,antimicrobial used by three generations of the first cephalosporins ranking dropped to fourth in 2010,the hospital infection rate decreased from 3.08% in 2006 to 2.07% in 2010,the hospital infection rate decreased from 15.5% in 2006 to 1.63% in 2010,the submission rate of therapeutic medicine etiology increased from 34.20 % in 2006 to 59.22% in 2010.CONCLUSION It is the comprehensive way to standardize the reasonable use of antibiotics and prevent and control nosocomial infections through the joint management of multiple departments,comprehensive targeting and targeting surveillance,focusing on the key training according to the problems in the monitoring,and the multi-channel continuous interventions.更多还原