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目的：通过分析抗菌药物临床应用专项治理前后住院患者抗菌药的使用情况，以促进合理用药。方法：随机抽取我院2010 年1 至2011 年12 月病例1680 份，抽取甲状腺/ 乳腺/ 疝气/ 闭合性骨折I 类切口手术病历100 份，分析治理前后抗菌药物使用率、使用强度、病原送检率、DDDs、DUI 及I 类切口抗菌药物应用情况。结果：治理前住院患者抗菌药物使用率、使用强度分别为 68.50%、49.8DDD；治理后分别为56.2%、37.8DDD，显著降低（P＜0.05）。治理前有四种抗菌药物DUI＞1，依次为头孢哌酮/ 舒巴坦钠＞头孢噻吩钠= 头孢唑啉＞头孢呋辛；治理后有两种抗菌药物DUI＞1，依次为磺苄西林＞头孢哌酮/ 舒巴坦钠；治理后I 类切口手术患者预防使用抗菌药物比例略为下降，疗程符合率、用药合理率明显上升（P＜0.05）。结论：我院住院患者抗菌药使用情况基本达到《抗菌药物临床应用专项工作方案》要求。但在某些方面，如I 类切口使用率、疗程、用药选择上需要持续改进，应加强对I 类切口的监管力度，以确保用药的经济、有效、合理。

英文摘要:

Objective: To analyze the use of antibiotics in the patients of Tianmen First People's Hospital before and after Special Administration of rational use of antimirobial agents in order to promote clinical rational drug use. Methods: A total of 1680 medical records and 100 records of type I incision operation (thyroid/mammary gland/hernia/closed fractures) were randomly selected from January 2010 to December 2011. Statistically analyze the antibiotic use rate, total antibiotic use density, rate of etiological examination, DDDs, and DUI before and after Special Administration. And the antibiotic use of type I incision operation were evaluated. Results: The use rate of antibiotics was 68.5% in inpatients, and total antibiotic use density was calculated as 49.8 DDD/100 patient days before Special Administration, and respectively 56.2% and 49.8DDD after, showing obvious drop (P＜0.05). Before Special Administration, the DUI of 4 kinds of antibacterials were slightly greater than 1.0, which were in the following order: cefoperazone/sulbactam>cefalotin= cephazolin>cefuroxime. After Special Administration, the DUI of 2 kinds were slightly greater than 1.0, which were sulbenicillin> cefoperazone/sulbactam. The use rate of antibiotics for patients of type I incision operation were also reduced, and tha accordance rate of treating courses and drug rational user rate were increased (P＜0.05). Conclusion: The use of antibiotics in our hospital basically met the requirement of Special Work Plan for Clinical Antibiotics Use, but more efforts should be made to make a progress, for example, to be more careful in choosing Type I incision operation, course of treatment and cure with medicine, to enhance monitoring the use of antibiotics in Type I incision operation. Only in these ways could clinical rational drug use be economically and effectively enhanced.

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