OBJECTIVE: To investigate the change trend of defined daily dose system（DDDs） of arbapenem antibiotics after special management and rationality evaluation index after twice of interventions in Fuyang the Second People’s Hospital（hereinafter referred to as "our hospital"）

so as to provide scientific management basis for the rational application of carbapenems antibiotics in our hospital. METHODS: The sales data of carbapenem antibiotics before（2016） and after special management（from 2017 to 2019） from the special medical management system and the hospital information system in our hospital were collected.Totally 80 medical records of carbapenem antibiotics were randomly selected from Aug.to Sept.in 2018 and Aug.to Sept.in 2019

respectively

which were divided into the first intervention group and the second intervention group. Compare the rationality of carbapenem antibiotics DDDs before and after special management

and the indications of drug use

combined use

procalcitonin detection

and pathogen microbial submission after 2 interventions. RESULTS: The consumption sum of carbapenem antibiotics in our hospital increased from 2 214 300 yuan in 2016 to 3 075 700 yuan in 2018

and then decreased significantly to 2 029 300 yuan in 2019.The proportion of consumption sum of carbapenem antibiotics to total consumption sum of antibiotics decreased significantly from 17. 14% in 2016 to 6. 23% in 2019.The proportion of cumulative DDDs of carbapenem antibiotics to cumulative DDDs of antibiotics increased slowly from 5. 39% in 2016 to 5. 80% in 2017

and then decreased significantly to 3. 38% in 2019.The proportion of patients with appropriate drug indications increased from 53. 75% in the first intervention group to 72. 50% in the second intervention group

and the proportion of patients with proper drug selection increased significantly from 68. 75% in the first intervention group to 85. 00% in the second intervention group

the proportion of patients with records of procalcitonin detection

pathogen microbial examination and special application grade antibiotics increased from 52. 50%

66. 25% and 66. 25% in the first intervention group to 73. 75%

88. 75% and 83. 75% in the second intervention group

the differences were statistically significant（P<0. 05）.There was no statistically significant difference in the suitability of usage and dosage

solvent selection and solvent dose between the first and second intervention groups（P > 0. 05）. CONCLUSIONS: The specialized management of carbapenem antibiotics has dynamic trend of decreasing DDDs

consumption sum and consumption amount.The rational evaluation indexes after the second intervention

especially the suitability of drug indications and drug selection

were significantly improved compared with those after the first intervention

but the grasp of drug indications still needs to be improved.In order to avoid the increase of drug resistance of gram-negative bacteria caused by improper indications and abuse of carbapenem antibiotics

it is still necessary to strengthen the management of indications for clinical application of carbapenem antibiotics.