Investigation And Analysis On The Rationality Of The Use Of Antimicrobial Agents From Different Aspects In A Secondary Class A Hospital

Aims:To make a survey and a comprehensive analysis of the use of antimicrobial agents in a Secondary Class A Hospital from Jan. 1,2007 to Dec.31,2007 and to study the consuming characteristics of antimicrobial agents and work out a reasonable plan for the hospital to purchase antimicrobial agents,optimizing its storage and capital use;to evaluate the use of antimicrobial agents of all kinds of patients and provide grounds for medical service and proper treatment to guarantee the safety of patients and reduce their economic burden as well.Methods:Collecting consuming statistics of antimicrobial agents by the Information Center using computer,including the consumed money of total drugs and antimicrobial agents,the ratio of the antimicrobial agents to the medicine used,the varieties of used antimicrobial agents(including formulation,specification, quantity,amount and so on).Analyzing the consumed money of antimicrobial agents by using A,B and C,studying the consumption characteristics and ways of storage.Drawing out 100 clinic prescriptions with antimicrobial agents every month and analyzing the rationality of the use of antimicrobial agents,casually drawing out 20 cases of nonsurgical inpatients and 10 cases of ordinary surgical inpatients(operations of thyroid and cesarean section excluded),10 cases each of thyroid surgery and cesarean section as samples,analyzing the datas by using charts(including varieties,days,ways,purposes of the use of antimicrobial agents,incision types and use ofantimicrobial agents duringperi operation period);Evaluating the rationality of using antimicrobial agents and also knowing about the situation of pathogenic examination and drug-sensitivity test.Results" During the survey,the hospital has used 16 categories of antimicrobial agents with 91 product varieties,of which 15 belong to A,15 belong to B and 61 belong to C,respectively occupying 69.25%,20.36%and 10.39%of the total amount of money on antimicrobial agents and they each occupy 48.85%,24.78%and 26.38%of the DDDs of the overall antimicrobial agents.The cost of antimicrobial agents accounts for 33.55%in total drugs in the hospital,while the rate of outpatients and inpatients is 35.18% and 32.93%respectively;The cost of injection antimicrobial agents accounts for 83.64%in antimicrobial agents,of which for outpatients is 46.33%and that for inpatients is 98.92%. Antimicrobial agents are widely used in every clinic department. Outpatient use of antimicrobial agents occupies 45.61%and inpatient occupies 87.66%.The antimicrobial agents' use of the non-surgical inpatients occupies 82.96%and the surgical inpatients 98.99%.The injection use of antimicrobial agents of outpatients,who usually take medicine orally,occupies 26.68%and that of the inpatients occupies 94.67%.The average using rate of combined antimicrobial agents of the outpatients and inpatients are 29.35%and 72.18%respectively.The pathogenic examination rate of nonsurgical inpatients using antimicrobial agents is 3.59%; the rate of drug-sensitivity test is 1.54%only,no pathogenic examination records for the surgical patients.None of the use for operation cases reached the standards of the Guiding Principles of Clinical Application of Antibacterials.Conclusions:Almost every category of antimicrobial agents is used in the Secondary Class A Hospital,which occupies a large portion of medicine consumption,especially newly invented antimicrobial agents,so the hospital should control the storage of antimicrobial agents,appropriately reduce the inventory cycle, reduce capital occupation and improve efficiency in the use of funds.There are many irrational phenomena in using antimicrobial agents such as wide use of expensive newly invented antimicrobial agents,too much preventive and combined use of it.There are improper administration and frequent change drugs and other issues in inpatient;the phenomenon of irrational use of surgical inpatient is more serious than non-surgical inpatient.The pathogenic examination and drug-sensitivity test is too low.In order to improve the status quo of the use of antimicrobial agents,related bureaus should work out effective systems for antimicrobial agents use,and supervise its use.The hospital should have a better control of the use of antimicrobial agents and train all the doctors on the rational use,especially intensify the learning of the Guiding Principles of Clinical Application of Antibacterials and pay more attention on the pathogenic examination and drug-sensitivity test,strengthen the construction of hospital pharmacy to meet the needs of modern medical service.