目的：分析上海市闵行区不同级别医院抗菌药物用药特点，为临床合理用药提供参考。方法：采用回顾性分析方法，对区内15家医院2014年抗菌药物用药金额、用药频度、限定日均费用等指标进行统计分析。结果：2014年本区抗菌药物购药总金额10905.79万元，其中二级医院占48.02%，口服的头孢菌素类头孢呋辛酯、头孢克洛和头孢地尼在一、二、三级医院分别位居第一。购药金额最高是二级医院注射阿奇霉素653.81万元，超过400万元的注射剂型是头孢噻肟钠（二级医院）、阿奇霉素、头孢美唑（三级医院），口服阿奇霉素与注射用左氧氟沙星在二级医院用药频度最高，分别为52.13、6.74。头孢菌素类占全部抗菌药物购药金额的44.88%，DDC最高为三级医院的哌拉西林钠-他唑巴坦钠（207.79元）。结论：应继续加强限制使用级和特殊使用级抗菌药物的临床应用管理，促进临床合理使用抗菌药物。%Objective:To analyze the medication features of antibacterial agents in hospitals of various levels in Minhang District, for providing reference for clinical rational use of the antibiotics.Methods: We conducted a retrospective analysis on the indexes of antibacterial agents, such as purchase amount, DDDs and DDC, which were collected and analyzed from 15 hospitals in 2014.Results: In 2014, the expenditure of antibiotics was 109.057 9 million yuan, of which the GradeⅡhospitals accounted for 48.02%. Among oral cephalosporins, cefuroxime, cefaclor and cefdinir ranked the ifrst place in GradeⅠ,ⅡandⅢhospitals, respectively. The expenditure of injectable azithromycin in GradeⅡhospitals was the most (6.538 1 million yuan). The antibiotics in injectable form, whose costs were over 4 million yuan, were cefotaxime sodium (GradeⅡhospitals), azithromycin and cefmetazole (GradeⅢhospitals). Oral azithromycin and injectable levofloxacin had the highest DDDs in GradeⅡhospitals (52.13 and 6.14, respectively). Cephalosporins accounted for 44.88% of all expenditure in antibacterial agents. The highest DDC was the piperacillin sodium and tazobactam sodium, which was 207.79 yuan in GradeⅢhospitals.Conclusion: We should continue to strengthen the management of antibacterial drugs, especially on the use of restricted and special purpose of antibiotics.
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