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OBJECTIVE:To investigate the relationship of drug utilization index(DUI)of antibiotics with therapeutic efficacy of patients with acute exacorbation of chronic obstructive pulmonary disease(AECOPD). METHODS:By the method of drug utili-zation evaluation,inpatients with AECOPD in our hospital during 2013-2015 were selected as the research object. Diagnosis and treatment information prescribing information of patients were collected,and inpatients only receiving one kinds of antibiotics dur-ing hospitalization stay were selected to evaluate the relationship of therapeutic efficacy with rehospitalization indexes. RESULTS:A total of 2155 AECOPD patients were enrolled in the study. Among antibiotics with DDDs>500,antibiotics with DUI close to 1.0 was cefotiam hydrochloride for injection,and that with DUI far higher than 1.0 was Cefodizime sodium for injection,while that with DUI much less than 1.0 was Piperacillin sodium and sulbactam sodium for injection. There was statistical significance in therapeutic efficacy between Cefotian hydrochloride for injection and Piperacillin sodium and sulbaactam for injection (P0.05). There was no statistical significance in therapentic efficacy or rehospital-ization between cefotiam hydrochloride for injection and cefodizimes sodium for injection(P>0.05). CONCLUSIONS:DUI is as-sociated with therapeutic efficacy,but the rationality of antibiotics can not be simple judged according to the distance between DUI and 1.0. A variety of confounding and bias factors should be integrated to avoid misreading and misjudgment.
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Objective:To evaluate the rationality of drug use in the children with rotavirus enteritis by the children drug utilization index ( cDUI) . Methods:A retrospective analysis was used to investigate the cDUI, DDDs and rationality of cimetidine, saccharomy-ces boulardiiand and ganciclovir used in 78 children with rotavirus enteritis. Results and Conclusion: The value order of DDDs was saccharomyces boulardii>cimetidine >ganciclovir. Moreover, the dosage of cimetidine and saccharomyces boulardii was relatively high, while that of ganciclovir was basically rational.
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OBJECTIVE:To provide a reference for clinical use of anti-tumor adjuvant drugs as is reasonable,effective and economical. METHODS:By retrospective investigation and analysis,the utilization of anti-tumor adjuvant drugs in the oncology department of our hospital during 2010 and 2013 was analyzed statistically in respect of the type,dosage form,consumption amount,DDDs,DDC,DUI etc. RESULTS:The anti-tumor adjuvant drugs in our hospital were dominated by injections,especial-ly domestic drugs,the consumption amount of which accounted for 80% of the total consumption amount of anti-tumor adjuvant drugs each year. The anti-tumor adjuvant drugs were mainly used for symptomatic treatment of various adverse reactions. Drug syn-chronization was relatively good each year,however,excessive use of individual drugs existed. CONCLUSIONS:Anti-tumor adju-vant drugs have relatively better synchronism in the drugs quantities and medication number. However,individual drugs have exces-sive use and other irrational use.
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Objective To research the pathogenies' types and analyze the antibacterial drug' s using rationality from the children with acute respiratory infection,our study were generated by pediatric department from the hospital lasting 2 years.Methods A total of 93 pediatric patients with acute respiratory infection admitted from December 1,2010 through November 30,2012 were enrolled into study.The throat swabs from 93 patients were sent to the Beijing Center for Disease and Prevention (CDC) to identify the influenza virus,syncytial virus and mycoplasma with rapid nucleic acid test.The specimens of sputum from hospitalized patients were sent to the hospital bacterial laboratory for bacteria culture.With the Children Drug Utilization Index (cDUI),the rationality of using antibiotics was estimated.The database was established by using SPSS version 18.0 software and the data were analyzed to determine the statistical distinction among the percentage by the Chi square test (P ＜ 0.05).Results Of them,70.96％ pediatric patients were below 3 years old (excluding newborns).Of them,62.36％ patients had positive findings of viral infection.The predominant viruses of respiratory infection were syncytial virus accounting for 30.43％,the influenza viruses 24.63％ and the para-influenza virus 10.14％.The patients with positive results in vital test were more vulnerable to lower respiratory infection than those with negative results.The pneumonia patients with positive finding of syncytial virus accounted for 85.71％ (18 patients) in which the median cDUI was 1.30.The antibiotics were given to 28 pneumonia patients with positive virus test,in which the median cDUI was 1.05.Of 28 pneumonia patients,4 (16％) had positive bacteria growth in sputum cultures,and 4 cases (16％) had positive bacteria growth in blood cultures.Conclusions In the district of hospital,the lower respiratory infection was usually caused by viruses.Therefore,antibiotics should not be given in patients without evidence of bacterial infection.It is a irrational strategy to use antibiotics in those patients when the Children Drug Utilization Index is high (＞ 1.0).It is paramount important to notice that the percentage of positive bacteria growth in sputum cultures is usually not high because the antibiotics are given by OPD physicians before hospitalization of patients with bacterial infections in the acute respiratory illness.
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Objective To investigate anti-ulcerative drug use in patients undergoing arthroscopic operation against stress ulcer. Methosds A total of 297 patients undergoing arthroscopic operation during Jan. to Aug. 2013 in our hospital were recruited and retrospectively analyzed with Excellspreadsheet. Results Among 297 patients in the study, ninety-four patients (31.6%) used AUD before operation, most (94.9%) administered by intravenous, and drug utilization index was 1.35. Ninety-eight point nine patients used proton pump inhibitors (PPIs) in which Lansoprazole was prescribed most. Conclusion This study highlights the overuse of PPIs in patients undergoing arthroscopic operation.
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Objective To analyze the etiological results and clinical characteristics in infants with acute pneumonia at the age of 0 ～ 1 years and to evaluate the rationality of the use of antibiotics.Methods Thirty-four infants hospitalized during Dec 2010 to Nov 2012 were selected.The throat swabs were sent to the Beijing Disease Prevention and Control Center for rapid nucleic acid test for influenza; the sputum was sent to the bacteriological laboratory of the hospital for the bacterial culture.Children drug utilization index (cDUI)was used to assess the rationality of the medication amount of antibiotic drugs.For defined daily dose statistic (DDDs),the larger the value of DDDs,the more frequent the clinical use of the drug.Results In the confirmed cases of acute pneumonia,21 cases were of viral infection,9cases were of bacterial infection and 4 cases were of mixed infection.The probability of bacterial pneumonia (4/9) was higher than that of viral pneumonia(5/21) in the case with underlying disease (P ＜0.001) ;the virus detection rate(12/21) of children with contact history with respiratory tract infection patients was higher than bacteria detection rate(4/9)(P =0.01).In case of no risk of cross infection,the infants were more susceptible to bacterial infection (P =0.006).The sputum culture of 25 cases of positive virus detection showed 13 cases of colonization of conditional pathogenic bacteria and 4 cases of pathogenic bacteria.The ratio of combination use of antibiotic drugs in case of bacterial infection (4/9) was higher than that in mixed infection (1/4) (P =0.001).The durations of the use of antibiotic drugs for every group showed no statistical difference (P =0.29).This research involved 7 antibiotic drugs.The medication frequencies and durations of ceftriaxone (DDDs =1813.45,total medication duration =187 days) and cefuroxirne (DDDs =1513.73,total medication duration =162 days) were higher than those of the other 5 antibiotic drugs.The cDUI of all drugs ≤ 1.0.The decreasing order of drugs by cDUI was amoxicillin and clavulanate potassium (cDUI =1.0),cefuroxime (cDUI=0.89),ceftriaxone (cDUI =0.87),azithromycin oral agent and cefepime (cDUI =0.80),midecamycin oral agent (cDUI =0.75) and penicillin injections (cDUI =0.50).Conclusion Virus is the main pathogen of the acute pneumonia in children in this research.Virus provides preliminary conditions for bacterial colonization.The overuse of ceftriaxone aggravates the pathogenic risks of conditional pathogenic virus.Some children are treated by antibiotic drugs for a long time or by the combination use of drugs,which are irrational mediation.
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OBJECTIVE:To investigate the feasibility of defined individual treatment course as evaluation index of rational use of drugs.METHODS:The doses of antibiotics and treatment course in 63 patients with type Ⅰ incision operation of our hospital in Jan.2010 were taken as examples.Case analysis,DUI evaluation and defined individual treatment course evaluation were adopted.Similar results were obtained by 3 kinds of methods.RESULTS&CONCLUSION:Results of 3 kinds of methods are consistent.DUI evaluation isn't closely associated with treatment course.Defined individual treatment course is more sensitive and available than DUI based on the introduction of dose and treatment course.
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OBJECTIVE:To evaluate the status quo and the rationality of the drug utilization in patients with chronic hepatitis B in our hospital.METHODS:The methods of drug utilization review (DUR) and drug utilization evaluation (DUE) were used to comprehensively analyze the drug utilization,diagnosis,monitoring of therapeutic process as well as therapeutic outcome of 78 patients with chronic hepatitis B hospitalized in our hospital from April 2007 to April 2008.RESULTS:Of the 78 cases reviewed,2 were treated with 1 kind of drug,and 76 with at least 2 kinds of drugs in combination;pathological staging was performed for only 6 cases,all of the 78 underwent therapeutic monitoring during therapeutic process.The DUIs of 11 kinds of drugs were more than 1,DUI
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OBJECTIVE:To investigate the utilization of narcotic analgesics in patients with cancerous pain in our hospital. METHODS:The consumption of Morphine and Pethidine in our hospital in 2004～2007 was analyzed statistically. RESULTS:The consumption quantity of Morphine sulfate controlled-release tablets has been on the rise from 2004 to 2007,while that of Morphine Hydrochloride Injection experienced little change and that of Pethidine Hydrochloride Injection showed a downward trend. CONCLUSION:The structure for the use of narcotic analgesics in our hospital tends to be reasonable,which is basically in line with the Guiding Principle of Pain Relief Ladder for Cancer Pain.
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OBJECTIVE: To investigate the drug use involved in outpatient's prescriptions in a hospital in 2007.METHO-DS: With the International Selected Drug Use Indicators and defined daily dose as indexes,the drug use involved in a total of 5 029 outpatient's prescriptions randomly selected from a hospital were analyzed statistically based on Excel sheet.RESULTS: Of the total 5 029 outpatient prescriptions,60.83% paid the expenses at one's own expense,and the average age of the patiens were 46.9 years.The average number of drugs prescribed for patient's each visit was 2.63 kinds,and the percentages of antibacterial agents,ampuls,and prescriptions of drugs prescribed in generic names were 21.79%,10.44%,and 50.47%,respectively.Quinolones,cephalosporins and macrocyclic lactones ranked at the first three places in DDDs and consumption sum.The drug utilization indexes of cephalosporins and penicillins were on the high side.23.72% of antibacterial agents used in combination and 76.28% alone,20.07% in bigeminy.The antibacterial agents used in trigeminy or more than 3 kinds in combination were all for antiuberculotic treatment.Physician's signature rate after prescription revision was 60.19%,and the rate of prescriptions in which medicines for oral administration or for external use were prescribed alone was 32.88%.CONCLUSION: The drug use for the outpatients in the hospital is rational on the whole,but measures should be taken to tighten control on the drug use by strenthening physicians' consiousness on rational drug use so as to reduce the incidence of irrational drug use.
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OBJECTIVE:To evaluate the utilization of narcotic analgesic drugs in outpatients of our hospital.METHODS:Narcotic analgesic drugs prescribed in outpatient prescriptions of our hospital from Aug.2005 to Aug.2006 were analyzed retrospectively.RESULTS:Among patients over 60 years old,the ratio of using pethidine hydrochloride injections and all narcotic analgesic drugs is significantly higher in those with cancer pain than those without(P
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OBJECTIVE:To evaluate the application status of narcotic analgesics in the inpatients of our hospital.METH-ODS:The prescriptions of narcotic analgesics of inpatients in 2005 were analyzed statistically in respect of the total number of prescriptions,name and specification of drugs,dosage and administration,duration of medication,total consumption quantity,and medication purpose etc with defined daily dose(DDD) and drug utilization index(DUI) as indexes.RESULTS & CONCLUSION:The DUI of all the five narcotic analgesics used in our hospital were ≤1.00,which is in line with the principle of Three-step Analgesic Ladder Approach for Caner Pain recommended by WTO.
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OBJECTIVE: To evaluate the utilization status of the second category of psychotropic drug in our hospital.METHODS: By a retrospective method,the utilization of the second category of psychotropic drug in our hospital was analyzed statistically.RESULTS: The second category of psychotropic drugs used in our hospital totaled 11 kinds(two dosage forms).Leading the first 5 places on the list of DDDs were Clonazepam tablets,Zolpidem tablets,Lorazepam tablets,Alprazolam tablets and Estazolam tablets.Leading the first 5 places on the list of consumption sum were Zolpidem tablets,Lorazepam tablets,Clonazepam tablets,Midazolam injections and Alprazolam tablets.CONCLUSION: The clinical utilization of second category of psychotropic drugs in our hospital was basically reasonable;however,some drugs were abused.
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OBJECTIVE:To probe into the utilization of sedative hypnotics in outpatient prescriptions of our hospital. METHODS: In Mar. 2008, 1 317 prescriptions of sedative-hypnotics randomly selected from total 49 791 outpatient prescriptions were analyzed regarding the rationality of the utilization of top 5 drugs on the list of DDDs. RESULTS: The top 5 sedative hypnotics on the DDDs list were Alprazolam tablets, Estazolam tablets, Lorazepam, Zolpidem tablets (Stilnox) and Clonazepam tablets, and their DUIs were 0.54, 0.73, 0.19, 0.81 and 0.53, respectively. CONCLUSION: The dosages of sedative hypnotics in our hospital were basically reasonable and in conformity with the indications listed in package inserts.
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OBJECTIVE:To evaluate the utilization and tendency of calcium products and calcium absorption enhancers in our hospital.METHODS:The calcium products and calcium absorption enhancers used in our hospital from 2005 to 2007 were analyzed statistically in respect of drug variety,consumption quantity,consumption sum and DDDs.RESULTS:Compound Calcium Amino Acid Chelate Capsules and Calcium Carbonate Chewable Tablets took the lead in clinical application.Leading the list of DDDs were Compound Calcium Amino Acid Chelate Capsules(Osteoform Capsules),Calcium Carbonate Chewable Tablets and Oyster Shell Tablets Calcium,however,the old generation calcium products had gradually become out of date.CONCLUSION:The use of calcium products and calcium absorption enhancers in our hospital was rational on the whole,but there are some problems which call for attention.
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OBJECTIVE: To investigate the application and trend of oral antidiabetic drugs in our hospital. METHODS: The use of oral antidiabetic drugs in our hospital in 2006 was analyzed retrospectively in respect of consumption sum, DDDs, drugs daily cost (DDC) and drugs utilization index (DUI) etc. RESULTS: The top 3 antidiabetic drugs in respect of consumption sum were acarbose, gliquidone and glipizide. The top 3 antidiabetic drugs in respect of DDDs were metformin, glipizide and acarbose. CONCLUSION: The use of oral antidiabetic drugs used in our hospital is rational on the whole, leading the list were biguanides, sulfonylurea and glycosidase-inhibitors.
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OBJECTIVE:To evaluate the utilization information of drug combination in tuberculosis control item in Shaoguan and the economics effect.METHODS:The defined daily dose(DDD)and drug utilization index(DUI)were taken as indexes for the evaluation of rational use of drugs,the utilization of chemotherapy drugs of the tuberculosis control item in Shaoguan urban field from1993to2003was analyzed;the cost-effectiveness of scheme B(tuberculosis control item chemotherapy)and scheme A(conventional chemotherapy)were analyzed.RESULTS:DUI for all of the drug combinations except B4were no more than1(DUI≤1),The cure rate(E 1 )and the effect rate(E 2 )for scheme B were96.5%and98.8%respectively;E 1 and E 2 in scheme A were65.7%and79.5%respectively.The cost-effectiveness ratio of scheme B was lower than that of scheme A.The cost-effectiveness ratio(C/E 1 )for the two schemes were8.59and25.31respectively if counted by cure rate and which(C/E 2 )were8.39and20.92respectively if counted by effect rate(E2).CONCLUSION:The utilization of tuberculosis control item drug combinations in Shaoguan city is comparatively reasonable and the economic effect is good.
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OBJECTIVE: To evaluate the preoperative utilization of antibacterial in orthopaedic patients in our hospital. METHODS: The preoperative use of antibacterial in 300 orthopaedic patients in our hospital in 2008 was reviewed. RESULTS: Of the 300 patients in our study, 100% of them were recieved preoperative antibacterial. Two of the most widely used antibacterials were clindamycin and cefuroxime sodium. The use of antibacterial in 228 patients were overtime after operation (76.00%), of which the use of antibacterial in 161 patients in type Ⅰ incision exceed 24 hour(70.61%), 56 patients in type Ⅱ incision exceed 2 days(24.56%) and 11 patients in type Ⅲ incision exceed 7 days (4.82%). CONCLUSION: The usage of preoperative antibacterial was inappropriate and the duration of administration is too long, which should be standardized.
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1 were also high in DDDs(i.e.high dosage).CONCLUSION: The patients undergoing uterine-incision delivery had a high proportion in using antimicrobial drugs yet the choice of drug kinds was reasonable.However,great attention should be paid to the high dosage of some of the antimicrobial drugs.