【摘要】 目的 提高医院临床科室抗菌药物使用合理性。方法 通过PASS临床药学管理系统与合理用药监测系统收集医院重症医学科2022年1月至6月（干预前）及2022年7月至12月（干预后）抗菌药物使用数据。建立临床药师参与的抗菌药物使用管理PDCA循环，设定目标值为抗菌药物使用强度（AUD）降至95 DDDs/百人天，并抽取该科室干预前后各200份病历评价抗菌药物合理使用情况。结果 干预后，该科室AUD由（107.64±8.79）DDDs/百人天降至（83.25±10.15）DDDs/百人天（P <0.01），抗菌药物的使用率、人均使用金额分别降低9.31%,938.29元；非限制使用级、限制使用级、特殊使用级抗菌药物使用率分别降低0.39%,5.32%,3.60%；出院患者抗菌药物使用率降低9.31%，单用率升高9.66%；抽检病例中抗菌药物不合理使用率降低13.00%，其中干预前主要不合理类型为用法用量不合理、无适应证用药、疗程不合理，干预后为用法用量不合理、疗程不合理。结论 临床药师参与抗菌药物使用管理PDCA循环，能有效控制AUD，提升抗菌药物使用合理性。更多还原

【Abstract】 Objective To promote the rational use of antibiotics in clinical departments of hospitals.MethodsThe data on theantibiotic use in the Intensive Care Unit of a hospital from January to June 2022(before intervention) and July to December2022(after intervention) were collected by the PASS clinical pharmacy management system and rational drug use monitoringsystem. A PDCA cycle for antibiotic use management participated by clinical pharmacists was established,with a target value ofantibiotics use density(AUD) decreasing to 95 DDDs/100 person-days. A total of 400 medical records before and afterintervention(200 for each time period) in the department were extracted to evaluate the rationality of antibiotic use.ResultsAfterintervention,the AUD of the department decreased from(107. 64 ± 8. 79) DDDs/100 person-days to(83. 25 ± 10. 15) DDDs/100 person-days(P < 0. 01),the antibiotic use rate and consumption sum per capita decreased by 9. 31% and CNY 938. 29,respectively. After intervention,the use rates of antibiotics for non-restricted use,restricted use and special use decreased by0. 39%,5. 32%,and 3. 60%,respectively. After intervention,the use rate of antibiotics in discharged patients decreased by 9. 31%,while the proportion of patients with single use of antibiotics increased by 9. 66%. After intervention,the irrational use rate ofantibiotics in case samples decreased by 13. 00%,the main types of irrational use before intervention were inappropriate usage anddosage,medication without indication,and inappropriate treatment course,those after intervention were inappropriate usage anddosage and inappropriate treatment course.ConclusionClinical pharmacists participating in the PDCA cycle for antibiotic usemanagement can effectively control the AUD and improve the rationality of antibiotic use.更多还原