Asensio Angel, Cantón Rafael, Vaqué Josep, Rosselló José, Arribas José Luis
Hospital Universitario Puerta de Hierro, Madrid, Spain.
Med Clin (Barc). 2002 May 25;118(19):731-6. doi: 10.1016/s0025-7753(02)72514-1.
Monitoring of antimicrobial use and knowledge of prescription habits are some of the strategies recommended to contain the resistance to antimicrobials in hospitals.
We analyzed a series of 10 annual studies of prevalence during the period 1990-1999 (EPINE project) in Spanish hospitals. Estimates of antimicrobial use were calculated as the percent distribution of every antimicrobial related to the overall antimicrobials prescribed.
Among 484,013 hospitalized patients, 34 to 36% were receiving antimicrobials (antibiotics > 90%). Amoxicillin-clavulanate use increased from 3.8% in 1990 up to 14.8% in 1999 (P < 0.01). Significant increases were also observed in the use of carbapenems (0.9 to 2.7%; P < 0.01), glycopeptides (1.7 to 3.7%; P < 0.01) and quinolones (8.5 to 11.3%; P < 0.01) though to a lesser degree. Conversely, the use of aminoglycosides decreased over the decade studied (15.8 to 9.4%; P < 0.01).
Even though the use of antimicrobials has increased over the last decade, current figures are within the ranges observed in other countries. The pattern of antibiotics use has changed during this period: while the use of aminoglycosides decreased, that of -lactams plus -lactamase inhibitors, quinolones and carbapenems increased.
监测抗菌药物的使用情况以及了解处方习惯是医院控制抗菌药物耐药性所推荐的一些策略。
我们分析了1990年至1999年期间西班牙医院进行的一系列为期10年的患病率研究（EPINE项目）。抗菌药物使用量的估计值以每种抗菌药物与所开具的所有抗菌药物的百分比分布来计算。
在484,013名住院患者中，34%至36%的患者正在接受抗菌药物治疗（抗生素占比超过90%）。阿莫西林克拉维酸的使用量从1990年的3.8%增至1999年的14.8%（P<0.01）。碳青霉烯类（从0.9%增至2.7%；P<0.01）、糖肽类（从1.7%增至3.7%；P<0.01）和喹诺酮类（从8.5%增至11.3%；P<0.01）的使用量也有显著增加，不过增幅较小。相反，在所研究的十年间氨基糖苷类的使用量有所下降（从15.8%降至9.4%；P<0.01）。
尽管在过去十年中抗菌药物的使用有所增加，但目前的数据仍在其他国家所观察到的范围内。在此期间抗生素的使用模式发生了变化：氨基糖苷类的使用量下降，而β-内酰胺类加β-内酰胺酶抑制剂、喹诺酮类和碳青霉烯类的使用量增加。
