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OBJECTIVE： To investigate the application of antidepressants in Zhejiang province and to provide reference for rational drug use in clinic. METHODS： WHO-recommended defined daily dose （DDD） method was used to statistically analyze consumption sum， main types， defined daily dose system （DDDs）， daily drug cost （DDC） and ranking ratio （B/A value， i.e. consumption sum rank/DDDs rank， B/A＜1 means the price of drugs was higher， whereas the price of drugs was lower） of antidepressant drugs in 11 hospitals from Zhejiang province during 2013-2017. RESULTS： The consumption sum of antidepressants was increased year by year in 11 hospitals from Zhejiang during 2013-2017， and increased from 3 235 200 yuan in 2013 to 4 569 100 yuan in 2017； the proportion of consumption sum of antidepressants in total consumption sum of all drugs kept stable， ranging from 0.47％ to 0.50％. The top 5 drugs by consumption sum were fluoxetine， duloxetine， olanzapine and venlafaxine； consumption sum of escitalopram accounted for a larger increase （proportion ration increased from 8th place in 2013 to first place in 2017）. Within 5 years， DDDs of fluoxetine， paroxetine and sertraline took up the first 3 place； DDC of olanzapine， quetiapine and duloxetine took up the first 3 place； the drugs with B/A value＜1 included duloxetine， olanzapine， venlafaxine and quetiapine， etc； the drugs with B/A value＞1 were paroxetine and sertraline. CONCLUSIONS： The use of antidepressant drugs in 11 hospitals from Zhejiang province is rational in structure； selective 5-hydroxytryptamine （5-HT） reuptake inhibitors （SSRI）， selective 5-HT and noradrenaline reuptake inhibitor （SNRI） take up the predominant place. New antidepressant drug escitalopram shows a good clinical prospect.
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OBJECTIVE:To provide reference for suitable selection of antibacterial ophthalmic preparation in the clinic. METHODS:The application of antibacterial ophthalmic preparation in a hospital during Jan. 2013-Dec. 2016 were summarized and analyzed to calculate DDDs. The results of bacterial culture and identification,drug sensitivity test were collected. The correlation of DDDs of antibacterial ophthalmic preparation with resistance rates of bacteria was analyzed by using Pearson test. RESULTS:During 2013-2016,there were 7 categories of antibacterial ophthalmic preparations used in this hospital,involving 10 types. To-tal DDDs showed an upward trend with average annual growth rate of 26.16％. DDDs of Tobramycin (dexamethasone) eye drops were the highest for consecutive 3 years (2013-2015). Gatifloxacin eye drops/eye gel and Ofloxacin eye drops/eye oint-ment ranged 2nd-4th place in the list of DDDs. A total of 26143 ocular specimens were examined,and 21 kinds of bacteria were detected,involving 6221 strains with detection rate of 23.80％. Top 3 bacteria in the list of detection rate were Staphylo-coccus epidermidis (3067 strains),Streptococcus pneumoniae (470 strains) and Staphylococcus aureus (321 strains). Resistance rates of above 3 kinds of bacteria to erythromycin were all higher than 70％,while they were sensitive to rifampicin,chlorampheni-col,gentamicin and levofloxacin,etc. Compared to previous year,the average resistance rates of rifampicin(in 2015),gentamicin (in 2015,2016),tetracycline(in 2015),ofloxacin(in 2014,2015),levofloxacin(in 2016)and gatifloxacin(in 2016)had statisti-cally significant differences(P0.05). CONCLUSIONS:The main ocular infec-tions were S. epidermidis,S. pneumoniae and S. aureus. DDDs of tetracycline is certainly associated with resistant rates. Regulating clinical use of antibacterial ophthalmic preparation is important for delaying the development of bacterial resistance.
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OBJECTIVE: To analyze the varieties, pharmaceutical utilization, adverse drug reaction(ADR) and majority problems in clinical use of poisonous traditional Chinese medicines in Beijing hospital, so as to provide references for their clinical rational use. METHODS: The varieties of Chinese patent medicines contain poisonous ingredients in Beijing hospital were surveyed, and their poisonous ingredients, drug categories, consumption sums, defined daily dose system(DDDs), adverse reactions and rational uses were analyzed. RESULTS: There were more than 300 Chinese patent medicines in Beijing hospital, in which 105 contained poisonous ingredients. Pharmaceutical utilization research indicated that most of the poisonous Chinese patent medicines with much higher consumption sums and DDDs were used for orthopedics and cardio-cerebrovascular diseases. In the statistics of ADR for 5 years in our hospital, 185 ADR reports of Chinese patent medicines were collected, among which poisonous Chinese patent medicines were involved in 49 ADR reports. CONCLUSION: The poisonous traditional Chinese medicines play important roles in clinical treatment, however, the adverse reaction rates of these medicines were much higher and may cause serious outcome. Therefore, their poisonous constituents and action mechanisms should be researched in depth constantly and the research should be linked with their clinical practices, so as to ensure the safe and rational use of poisonous traditional Chinese medicines.