Influence and Role of Comprehensive Intervention Measures on Clinical Application of Antibiotics

WANG Yuan; CUI Yonghua; XU Wei; WANG Yong

doi:10.14009/j.issn.1672-2124.2021.07.024

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Influence and Role of Comprehensive Intervention Measures on Clinical Application of Antibiotics

更新时间：2022-10-08

- Influence and Role of Comprehensive Intervention Measures on Clinical Application of Antibiotics
- Vol. 21, Issue 7, Pages: 876-880(2021)
- 作者机构：
  
  1. 南通大学医学院
  2. 南通大学附属建湖医院神经外科
  3. 南通大学附属建湖医院药学部
- 作者简介：
- 基金信息：
- DOI：10.14009/j.issn.1672-2124.2021.07.024
  CLC： R95
- Published：2021，
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WANG Yuan, CUI Yonghua, XU Wei, et al. Influence and Role of Comprehensive Intervention Measures on Clinical Application of Antibiotics. [J]. 21(7):876-880(2021)
DOI：

WANG Yuan, CUI Yonghua, XU Wei, et al. Influence and Role of Comprehensive Intervention Measures on Clinical Application of Antibiotics. [J]. 21(7):876-880(2021) DOI： 10.14009/j.issn.1672-2124.2021.07.024.

摘要

目的:了解南通大学附属建湖医院(以下简称"该院")抗菌药物临床应用情况

为深化管控抗菌药物临床应用提供参考。方法:该院于2019年3月开始推行事前、事中和事后全程闭环综合干预措施

分别调取干预前(2018年7—12月)、干预后(2019年7—12月和2020年7—12月)该院住院患者抗菌药物使用数据

对干预前后抗菌药物使用率、使用强度

各类抗菌药物销售金额及占药品总销售金额的比例

以及特殊使用级抗菌药物的用药频度(defined daily dose system

DDDs)及其占抗菌药物总DDDs的比例进行统计分析。结果:干预前(2018年7—12月)

该院住院患者抗菌药物使用率为53.91%(12 179/22 590);干预后

该院住院患者抗菌药物使用率明显降低

2019年7—12月为51.78%(13 608/26 281)

2020年7—12月为50.39%(12 095/24 004)

与干预前的差异均有统计学意义(P <0.01)。干预前

该院住院患者的AUD为45.52 DDDs/(100人·d);干预后

该院住院患者的AUD明显降低

2019年7—12月为40.24 DDDs/(100人·d)

2020年7—12月为39.68 DDDs/(100人·d)

与干预前的差异均有统计学意义(P <0.01)

但2019年7—12月与2020年7—12月的差异无统计学意义(P> 0.05)。干预前后

抗菌药物销售金额占同期药品总销售金额的比例逐渐降低

2018年7—12月、2019年7—12月和2020年7—12月依次为16.89%(936.53万元/5 544.85万元)、15.44%(975.74万元/6 319.32万元)和15.13%(876.04万元/5 791.93万元);特殊使用级抗菌药物DDDs占抗菌药物总DDDs的比例表现为先降后升

2018年7—12月、2019年7—12月和2020年7—12月依次为5.60%(4 997.25/89 300.46)、4.61%(4 278.38/92 724.24)和5.29%(4 779.33/90 346.50)。结论:该院实施的综合干预措施可行、有效

能够促进抗菌药物合理、规范应用

但是质控指标仍需持续改进。

Abstract

OBJECTIVE: To investigate the clinical application of antibiotics in Jianhu Hospital Affiliated to Nantong University（ hereinafter referred to as "the hospital"）

so as to provide reference for deepening the control of clinical application of antibiotics. METHODS: In Mar. 2019

the hospital started to implement the closed-loop integrated intervention before

during and after the whole process

and retrieved data on clinical application of antibiotics for inpatients in the hospital before（ from Jul. to Dec. 2018） and after（ from Jul. to Dec. 2019 and from Jul.to Dec. 2020） the intervention respectively. The application rate and intensity of antibiotics

consumption sum of all kinds of antibiotics and the proportion in total consumption sum

and the defined daily dose system（ DDDs） of antibiotics for special application and the proportion in total DDDs were statistically analyzed before and after intervention. RESULTS: Before intervention（ from Jul. to Dec. 2018）

the application rate of antibiotics in inpatients in the hospital was 53. 91%（ 12 179/22 590）. After intervention

the application rate of antibiotics in inpatients in the hospital decreased significantly

which was 51. 78%（ 13 608/26 281） from Jul. to Dec. 2019 and 50. 39%（ 12 095/24 004） from Jul. to Dec. 2020

with statistical significance compared with that before intervention（ P < 0. 01）. Before intervention

the AUD of inpatients in the hospital was 45. 52 DDDs/（ 100 persons·d）. After intervention

the AUD of inpatients in the hospital decreased significantly

which was 40. 24 DDDs/（ 100 persons·d） from Jul. to Dec. 2019 and39. 68 DDDs/（ 100 persons·d） from Jul. to Dec. 2020

with statistical significance compared with that before intervention（ P < 0. 01）. However

there was no significant difference between from Jul. to Dec. 2019 and from Jul. to Dec. 2020（ P > 0. 05）. Before and after intervention

the proportion of consumption sum of antibiotics in the total consumption sum of drugs in the same period decreased. From Jul. to Dec. 2018

from Jul. to Dec. 2019

and from Jul.to Dec. 2020

the proportions were respectively 16. 89%（ 9 365 300 yuan/55 448 500 yuan）

15. 44%（ 9 757 400 yuan/63 193 200 yuan） and 15. 13%（ 8 760 400 yuan/57 919 300 yuan）. The proportion of DDDs of antibiotics for special application in total DDDs of antibiotics decreased first and then increased. From Jul. to Dec.2018

from Jul. to Dec. 2019 and from Jul. to Dec. 2020

the proportions were respectively 5. 60%（ 4 997. 25/89 300. 46）

4. 61%（ 4 278. 38/92 724. 24） and 5. 29%（ 4 779. 33/90 346. 50）. CONCLUSIONS: The comprehensive intervention measures implemented by the hospital are feasible and effective

which can promote the rational and standardized application of antibiotics

yet the quality control indicators still need to be continuously improved.

关键词

抗菌药物临床应用综合干预影响作用

Keywords

AntibioticsClinical applicationComprehensive interventionInfluence and role

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