【摘要】 目的 评价临床药师干预对医院住院患者抗菌药物使用的影响，为抗菌药物的合理使用提供参考。方法 选取华中科技大学同济医学院附属梨园医院2023年2—9月未开展临床药师干预的住院患者690例作为临床药师干预前，2024年2—9月开展临床药师干预后的住院患者689例作为临床药师干预后。比较临床药师干预前后住院患者抗菌药物使用率、抗菌药物使用强度(AUD)及用药不合理情况。结果 临床药师干预前医院住院患者抗菌药物使用率维持在50%以上，干预后呈现下降趋势，自2024年3月起稳定控制在50%以下。临床药师干预后医院住院患者AUD呈持续下降趋势，至2024年4月达到国家规定标准[<40 DDDs/(100人·d)]，后保持稳定达标状态。临床药师干预后，多数临床科室住院患者抗菌药物使用率降低，其中疮疡科、骨科、泌尿外科、普通外科、神经外科等外科科室住院患者降低明显。临床药师干预后，医院住院患者无指征选用抗菌药物、用药疗程过长和联合用药不合理发生率低于临床药师干预前，差异有统计学意义(P<0.05)。结论 临床药师多维度干预可降低医院住院患者抗菌药物使用率与AUD，减少不合理用药，但需持续优化以进一步规范抗菌药物使用。更多还原

【Abstract】 Objective To evaluate the effect of clinical pharmacist intervention on the use of antibiotics in hospitalized patients, and to provide reference for the rational use of antibiotics. Methods A total of 690 inpatients without clinical pharmacist intervention from February to September 2023 in Liyuan Hospital of Tongji Medical College of Huazhong University of Science and Technology were selected as before clinical pharmacist intervention, and 689 inpatients after clinical pharmacist intervention from February to September 2024 were selected as after clinical pharmacist intervention. The utilization rate of antibiotics, antibiotics use density(AUD) and irrational drug use before and after the intervention of clinical pharmacists were compared. Results Before the intervention of clinical pharmacists, the utilization rate of antibiotics in hospitalized patients in the hospital remained above 50%. After the intervention, it showed a downward trend and was stably controlled below 50% since March 2024. After the intervention of clinical pharmacists, the AUD of inpatients in the hospital showed a continuous downward trend, and reached the national standard [< 40 DDDs/(100 persons · d)] by April 2024, and then remained stable. After the intervention of clinical pharmacists, the utilization rate of Antibiotics in hospitalized patients in most clinical departments decreased, among which the inpatients in surgical departments such as Ulcer Department, Orthopedics Department, Urology Department, Heneral Surgery Department and Neurosurgery Department decreased significantly. After the intervention of clinical pharmacists, the incidence of non-indicative use of antibiotics, long course of medication and unreasonable combination of drugs in hospitalized patients was lower than that before the intervention of clinical pharmacists, and the difference was statistically significant(P < 0.05). Conclusions The multi-dimensional intervention of clinical pharmacists can reduce the utilization rate and AUD of antibiotics in hospitalized patients and reduce irrational drug use, but it needs to be continuously optimized to further standardize the use of Antibiotics.更多还原