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目的了解桂林医学院附属医院抗菌药物的使用现状,从而提高临床使用抗菌药物的合理性。方法对2010年11月8日0时～24时所有住院患者进行抗菌药物使用调查,由医院感染管理科、药剂科、护理部工作人员及临床科室医院感染监控医师组成10个调查小组,采用床旁调查、医护人员询问和病历调查相结合的调查方式,填写个案调查表。结果在所调查的1066例住院患者中,抗菌药物使用率为36.87%,抗菌药物联合用药率为18.32%,联合用药中两联用药占18.07%,三联用药占0.25%,无四联用药。抗菌药物预防性用药占30.53%,存在外科Ⅰ类切口手术围术期预防用药过度及内科疾病抗菌药物预防性应用指征不明确等问题。住院患者病原体培养及药敏试验的送检率为34.8%。结论治疗性用药病原学送检率较低,抗菌药物选用以经验用药为主,缺乏科学依据,需要加强抗菌药物合理应用的管理,提高抗菌药物应用水平。
Objective To understand the current situation of the use of antimicrobial agents in Affiliated Hospital of Guilin Medical College so as to improve the rationality of clinical use of antimicrobial agents. Methods All inpatients were investigated for antimicrobial use from 0:00 to 24:00 on November 8, 2010. Ten investigation teams were formed by hospital infection management department, pharmacy department, nursing department staff and clinical department of hospital infection monitoring physicians. Next investigation, medical staff inquiry and medical record investigation combined with the survey, fill in the case questionnaire. Results Among the 1066 hospitalized patients investigated, the antibacterial drug use rate was 36.87%, the antimicrobial drug combination rate was 18.32%, the combination therapy was 18.07%, the triple therapy was 0.25%, and no quadruple drug was used. Preventive drugs accounted for 30.53% of antimicrobial agents, there are surgical perioperative surgical incision I overdosage and medical diseases, antimicrobial prophylaxis indications are not clear and so on. Inpatient pathogen culture and drug susceptibility testing of the delivery rate was 34.8%. Conclusions The etiological detection rate of therapeutic drug is low, and the selection of antimicrobial agents is based on empirical medication. There is no scientific basis for the selection of antimicrobial agents. Therefore, it is necessary to strengthen the rational management of antimicrobial agents and improve the application of antimicrobial agents.