目的：分析特殊使用类抗菌药物的应用情况，促进该类药的合理应用和科学管理。方法：选取汕头潮南民生医院2013年7-12月特殊使用类抗菌药物的应用数据，包括销售金额、用药频度（DDDs）、药物利用指数（DUI）和科室分布等，并随机抽取120份特殊使用类抗菌药物住院患者病历，评价其用药合理性。结果：该院销售金额和DDDs列前两位的均是亚胺培南/西司他丁钠、美罗培南，分别达66.48万元（55.07％）、32.83万元（27.20％）和913.25、425.25；DUI除伏立康唑（0.68）偏低外，其他各药多数接近或超过1；呼吸科和ICU是使用特殊使用类抗菌药物数量和品种最多的科室。所抽查的患者病历中，存在适应证、疗程、用法用量、溶媒选择、联合用药等不合理情况，抗菌药物分级管理也存在执行不严的情况。结论：为了减少细菌对特殊使用类抗菌药物的耐药性，应加强该类药的合理应用，规范其管理，以保护该类药在治疗严重感染性疾病中的重要地位。%OBJECTIVE:To analyze the use of antibiotics for special use so as to promote rational use and scientific manage-ment of this kind of drugs. METHODS:The utilization data including consumption sum,DDDs,drug utilization index(DUI)and department distribution etc of the antibiotics for special use during July-December period of 2013 in Shantou Chaonan Minsheng Hospital were collected,and 120 medical records of the inpatients administered with antibiotics for special use were selected ran-domly for evaluation of the rationality in drug use. RESULTS:Imipenem/ cilastatin sodium and meropenem took the lead in both consumption sum [664 800 yuan(55.07%)vs. 328 300 yuan(27.20%)] and DDDs(913.25 versus 425.25). The DUIs of most of the drugs were near to or greater than 1 except that of voriconazole at 0.68. The use of antibiotics for special use in respiratory de-partment and ICU took the lead in both consumption amount and number of drug varieties. The medical records were found to be ir-rational in indications,course of treatment,usage and dosage,selection of solvents and drug combination. The hierarchical manage-ment of the antibiotics was not strict. CONCLUSIONS:To reduce the resistance of bacteria to antibiotics for special use,it is im-portant to emphasize the rational use of this kind of drugs and standardize their management to guarantee their important role in the treatment of serious infectious diseases.
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