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目的调查湖南武陵山片区56所乡镇卫生院抗菌药物的使用现状。方法随机抽取湖南武陵山片区56所乡镇卫生院门诊处方13 348张,非手术患者病历1 288份,手术患者病历280份,调查其抗菌药物使用情况。结果门诊患者、住院非手术患者、住院手术患者抗菌药物使用率为53.01%、87.97%、98.57%,联合用药率分别为19.57%、46.96%、39.86%。I类切口手术患者预防性使用抗菌药物比率为96.94%,联合用药率为36.84%。住院患者抗菌药物使用强度124.92 DDDs/100人·天。56所卫生院门诊处方中抗菌药物使用8 573种次,使用频率居前5位的分别为阿莫西林、头孢曲松、阿莫西林/克拉维酸钾、左氧氟沙星和克林霉素。结论湖南武陵山片区乡镇卫生院普遍过度使用、不合理使用抗菌药物。医务人员应加强学习,认真执行抗菌药物管理相关规定;卫生行政主管部门应加强对卫生院抗菌药物临床应用的监督管理,促进乡镇卫生院抗菌药物的合理使用。
Objective To investigate the use of antibacterials in 56 township hospitals in Wuling Mountain, Hunan Province. Methods A total of 13 348 outpatient prescriptions were randomly selected from 56 township hospitals in Wuling Mountain Area of Hunan Province, 1 288 medical records of non-surgical patients and 280 medical records of surgical patients. The use of antibacterials was investigated. Results The outpatients, inpatients and inpatients had an average of 53.01%, 87.97% and 98.57% of antibacterials, respectively. The rates of combination therapy were 19.57%, 46.96% and 39.86% respectively. The rate of prophylactic use of antibacterials was 96.94% in patients with type I incision surgery and the combined drug use rate was 36.84%. Inpatient antibacterial use intensity of 124.92 DDDs / 100 person-days. Of the 56 clinics in outpatient clinics, 8 573 antibacterials were used, with the top five frequency of use being amoxicillin, ceftriaxone, amoxicillin / clavulanate, levofloxacin and clindamycin respectively. Conclusion Hunan Wuling Mountain Area township hospitals generally over-used, irrational use of anti-bacterial drugs. Medical staff should strengthen their study and conscientiously implement the relevant provisions of antimicrobial drug administration; health administrative departments should strengthen the supervision and management of clinical application of antibacterial drugs in hospitals, and promote the rational use of antimicrobial drugs in township hospitals.