目的 了解我院60岁及以上老年住院患者抗菌药物的使用情况,评价其用药合理性.方法 回顾性分析我院2011年7-12月使用抗菌药物的老年患者出院病历资料758份并进行统计分析.结果共调查1 137份老年出院患者病历,758例使用了抗菌药物,使用率为66.67%,其中联合用药占63.06%(478/758).使用例次居前3位的药物种类分别是:头孢菌素类(35.16%,596/1 695)、β-内酰胺酶抑制剂复方制剂(21.71%,368/1 695)、喹诺酮类(18.70%,317/1 695);使用例次居前3位的药品分别为:注射用阿莫西林钠克拉维酸钾(19.40%,221/1 139)、头孢地尼胶囊(15.01%,171/1 139)、注射用头孢地秦钠(12.91%,147/1 139).44.99%(341/758)做了一般细菌培养及鉴定,31.13%(236/758)做了常规药敏试验.用药不合理的典型病历117份,占总病历数的15.44%.结论 我院老年住院患者抗菌药物的使用存在不合理性.抗菌药物合理使用仍需进一步规范.%Objective To evaluate the use of antibacterial drugs among inpatients over 60 years in our hospital. Methods Medical records of discharged patients who used antibacterial drugs between July and December 2011 were retrospectively studied. Results Totally 758 out of 1 137 ( 66. 67% ) medical records we investigated had used antibacterial drugs, with combination therapy accounting for 63. 06% ( 478/758 ). The top three antibacterial drug types regarding person - time use were cephalosporin ( 596/1 695, 35. 16% ), β - lactam/β - lactamase inhibitor ( 368/1 695, 21.71% ), and quinolones ( 317/1 695, 18. 70% ). The top three antibiotic agents were amoxicillin sodium and clavulanate potassium for injection ( 221/ 1 139,19.40% ), cefdinir capsule ( 171/1 139, 15.01% ), and cefodizime sodium for injection ( 147/1 139, 12.91% ). A-mong the 758 cases, 44. 99% ( 341/758 ) used bacterial culture and identification, and 31. 13% ( 236/758 ) used susceptibility testing. Irrational drug use occurred in 117 cases, accounting for 15. 44% of the total. Conclusion There is the irrationality in antibacterial drug use among the older inpatients in our hospital. Antibacterial drugs should be used with more caution and rationality in the future.
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