目的 了解社区医疗机构急性上呼吸道感染抗菌药使用情况,为促进基层抗菌药物合理使用提供依据。方法 筛选北京市东城区65家基层医疗机构2016年所有门诊急性上呼吸道感染处方,从药物种类、患者和医生特征等角度分析抗菌药物使用和联用情况。结果 2016年东城区社区医疗机构急性上呼吸道感染处方共164 575张,抗菌药处方率和抗菌药联用率分别为12.1%和0.6%;抗菌药物处方中,使用最多的是第二代头孢菌素类(60.2%)和大环内酯类(16.2%),没有使用指南推荐首选的青霉素类;男性、急性扁桃体炎或急性喉炎患者的抗菌药处方率显著更高,18~50岁患者的抗菌药使用和联用均显著高于50岁以上患者(P＜0.05);不同性别、学历和职称的医生抗菌药物使用和联用情况均存在显著差异(P<0.05)。结论 基层急性上呼吸道感染治疗中的抗菌药物滥用问题应该得到足够重视,定期对所有基层医生进行抗菌药物规范治疗的培训和继续教育十分必要。
Abstract
OBJECTIVE To investigate the use of antibacterials for patients with acute upper respiratory tract infections(AURIs) in community health care institutions in Dongcheng district, so as to provide references for rational use of antibacterials in primary health care institutions. METHODS All the outpatient prescriptions of AURIs patients from 65 primary health care institutions in Dongcheng district in 2016 were selected. The antibacterial and multiple antibacterial prescription rate were analyzed from the perspective of drug categories, patients′ and doctors′ characteristics. RESULTS This study included 164 575 AURIs prescriptions of community health care institutions in Dongcheng district in 2016. The antibacterial prescription rate(APR)was 12.1% and the multiple antibacterial prescription rate(MAPR) was 0.6%. The top antibacterials in the list of varieties were second generation cephalosporin(60.2%) and macrolide(16.2%), the penicillin preferred by the guidelines were not used. The APR for the male and patients with acute laryngitis or acute tonsillitis was higher. Compared with patients 18-50 years old,the use and combination of antibacterials for patients >50 years old werehigher(P<0.05).There were significant differences in the use and combination of antibacterials among doctors of different genders, education and titles(P<0.05). CONCLUSION The issue of antibacterial abuse in the AURIs treatment in primary health care institutions should be given sufficient attention. Regular standardized antibacterial treatments training and continuing education for all doctors in primary health care institution are necessary.
关键词
急性上呼吸道感染 /
抗菌药物 /
合理用药 /
基层医疗机构
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Key words
acute upper respiratory tract infection /
antibacterial /
rational use of medicine /
primary health care institutions
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中图分类号：
R952
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