【摘要】 目的 通过区域性处方点评数据，分析儿童用药特点及主要问题，探讨儿童合理用药的现状及问题难点，为其他地区提供借鉴。方法 分析2018—2020年北京地区区域性处方点评中儿童专科医院门急诊处方合理率、适应证、用法用量、禁忌证、重复用药及相互作用等6个点评项目的变化。对比儿童处方与总处方变化趋势，寻找儿童处方点评中主要不合理内容和所涉及药物，分析不合理用药的原因。结果 总处方中儿童处方占14.72%,儿童处方中西药处方占74.77%。儿童使用中成药比例高于总体水平。2019年儿童处方合理率最高，中成药处方合理率低于总体水平。西药最主要的不合理项目为适应证，其次为给药频次；中成药最主要的不合理项目为超剂量使用药品。西药排名前两位药物不合理项目均为给药途径，中成药排名首位药物不合理项目为重复用药。不合理药物经过规范后合理率得到大幅改善。结论 通过处方点评可以切实提高儿童处方合理率。儿童处方点评标准成为儿童处方点评的重点与难点。儿童中超剂量用药及中成药合理使用需要重点关注。更多还原

【Abstract】 Objective To analyze the characteristics and main problems of pediatric drugs by using regional prescription review data.To explore the current situation, the problems and difficulties of rational drug use in children, provide reference for other regions. Methods After collecting the regional prescription review data of Beijing from 2018 to 2020,we analyzed the reasonable rate and the unreasonable items of outpatient and emergency prescriptions in children’s specialized hospitals.We compared the change trend of children’s prescription and total prescription, looked for the main unreasonable items and unreasonable drugs in the pediatric prescription review, and analyzed the reasons for unreasonable drug use. Results Pediatric prescriptions accounted for 14.72% of the total prescriptions. A total of 74.77% of pediatric prescriptions were western medicine prescriptions.The proportion of children using traditional Chinese medicine was higher than the overall level.The reasonable rate of children’s prescription in 2019 was the highest. The reasonable rate of traditional Chinese medicine prescription is lower than the overall level.Indications were the main unreasonable items of western medicine, followed by the frequency of administration.Drug overdose was the main unreasonable item of traditional Chinese medicine.The top two unreasonable items in the ranking of western medicine were both the unreasonable routes of administration.The number one problem among the top 10 drugs ranked by the rate of unreasonable item of traditional Chinese medicine was repeated medication. The reasonable rate of unreasonable drugs had been improved after standardization. Conclusion The reasonable rate of pediatric prescriptions can be effectively improved through prescription comments.The formulation of children’s prescription review standards has become the core problem and difficulty of children’s prescription review.More attention should be paid to the over dose medication and rational use of traditional Chinese medicine in children.更多还原