Usluer Gaye, Ozgunes Ilhan, Leblebicioglu Hakan
Department of Infectious Diseases, Osmangazi University, Faculty of Medicine, Eskisehir, Turkey.
Ann Clin Microbiol Antimicrob. 2005 Oct 3;4:16. doi: 10.1186/1476-0711-4-16.
Accurate information about prescribing patterns in hospitals is valuable in improving the quality of antimicrobial prescriptions.
Data on the use of antimicrobial agents in eighteen tertiary care hospitals were collected on March 20th 2002.
One or more antimicrobials were ordered in 2900 (30.6%)of 9471 hospitalized patients. The reasons of hospitalization of the patients receiving antimicrobials were medical treatment (42.5%), elective surgery (39.6%), treatment of infectious disease (17.1%) and emergent surgical procedures (10.4%). The highest consumption frequencies were found in surgical (81.6%) and medical (55.2%) intensive care units. The 48.8% of antimicrobials were given for treatment and 44.2% for prophylactic use. The most common reasons for treatment were found as lower respiratory tract, urinary tract, surgical wound infections and febrile neutropenia. Antimicrobials were ordered empirically in 78.4% of patients. The proven infection ratio was found as 30.7%. The 56.4% and 13.4% of orders were evaluated as clinically and microbiologically appropriate respectively.
These results suggest that antimicrobial prescription and empirical treatment ratios were high and inappropriate at inpatient groups.
医院处方模式的准确信息对于提高抗菌药物处方质量具有重要价值。
于2002年3月20日收集了18家三级医疗机构抗菌药物使用的数据。
9471例住院患者中有2900例(30.6%)使用了一种或多种抗菌药物。接受抗菌药物治疗患者的住院原因包括内科治疗(42.5%)、择期手术(39.6%)、传染病治疗(17.1%)和急诊手术(10.4%)。抗菌药物使用频率最高的科室是外科重症监护病房(81.6%)和内科重症监护病房(55.2%)。48.8%的抗菌药物用于治疗,44.2%用于预防。治疗的最常见原因是下呼吸道感染、泌尿系统感染、手术伤口感染和发热性中性粒细胞减少症。78.4%的患者经验性使用抗菌药物。确诊感染率为30.7%。分别有56.4%和13.4%的医嘱在临床和微生物学方面被评估为合适。
这些结果表明,住院患者组的抗菌药物处方和经验性治疗比例较高且不合理。