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目的:分析抗菌药物分级管理干预措施的实施及效果。方法:选择2011年5月至2013年5月间我院全院出院患者6622例的病案资料。其中实施分级管理制度之前的患者3238例,实施分级管理制度之后的患者3384例,分析分级管理前后医院抗菌药物使用情况。结果:实施分级管理制度后抗菌药物使用率,人均使用频次及人均抗菌药物费用均明显降低,与实施分级管理制度前比较差异具有统计学意义(P<0.05)。实施分级管理制度后一线抗菌药物使用率显著提高,二线、三线抗菌药物使用率降低,与实施分级管理制度前比较差异具有统计学意义(P<0.05)。实施分级管理后三联用药比例显著降低(P<0.05),送检标本及检出阳性率较实施分级管理前无统计学意义(P>0.05)。结论:实施抗菌药物分级管理可以有效的限制抗菌药物滥用情况,对于临床抗菌药物合理应用有积极意义。
OBJECTIVE: To analyze the implementation of antimicrobial drug classification management interventions and their effects. Methods: The data of 6622 cases of discharged patients in our hospital from May 2011 to May 2013 were selected. Among them, there were 3,238 patients before the implementation of the classification management system and 3384 patients after the implementation of the classification management system, and analyzed the use of antimicrobial drugs in hospitals before and after the grading management. Results: The antimicrobial use rate, the frequency of per capita use and the per capita antimicrobial cost were significantly reduced after the implementation of the hierarchical management system, which was significantly different from that before the implementation of the hierarchical management system (P <0.05). After the implementation of the hierarchical management system, the first-line antibacterials utilization rate increased significantly, and the second and third-line antibacterials utilization rates decreased, which was significantly different from that before the implementation of the hierarchical management system (P <0.05). There was no significant difference (P> 0.05) in the proportion of triple drug administration after the implementation of the graded management and the positive rate of the tested drugs and the positive rate of the detected drugs before implementation of the grading management. Conclusion: The implementation of antimicrobial drug classification management can effectively limit the abuse of antimicrobial drugs, which has positive significance for the rational use of clinical antimicrobial agents.