ABSTRACT
Objective To investigate the comprehensive intervention of special-use-grade antibacterial agents and their effects on bacterial resistance in oncology department, and analyze the effects of comprehensive intervention. Methods The medical records of 63 patients discharged from January to June 2017 were used as the control group, and the medical records of 61 patients discharged from January to June 2018 were used as the intervention group. The changes in the indicators of special-use-grade antibacterial agents before and after the intervention were compared. Results After comprehensive intervention, the pass rate of online consultation of special-use-grade antibacterial agents increased from 65.34% to 98.00%, with a statistical difference (P<0.05). DUI values of linezolid, amitraconam, carbophenazim and voriconazole decreased from more than 1 to less than 1. The usage rate of single use antibacterial agents was significantly increased, and the usage rate of combination of antibacterial agents was significantly decreased (P<0.05). Main pathogenic bacteria for escherichia coli, klebsiella pneumoniae, pseudomonas aeruginosa, staphylococcus aureus, white smooth candida yeast and candida, and their constituent ratio had no significant change. Except for klebsiella pneumoniae, the resistance rate of imipenem increased by 16.67%, while resistance rate of other pathogens is in a downward trend. Conclusion The comprehensive intervention makes the clinical application of special-use-grade antibacterial agents in oncology department increasingly reasonable.
ABSTRACT
Objective:To analyze the indicators and resistance rate of antibacterial drugs for special use in our hospital before and after the implementation of network online approval process to provide reference for the management and rational use of antibacterial drugs for special use. Methods:A retrospective analysis was performed, and the consumption amount, sales amount, utilization ratio, AUD, submission rate of microbial specimen and resistance rates for the main pathogenic bacteria of antibacterial drugs and ones for special use were investigated during 2012 and 2015 in our hospital. Results:The approval process of antibacterial drugs for special use developed from handwork to network online. The consumption amount of antibacterial drugs increased slightly year by year from 2012 to 2015 in our hospital, the mean expense of antibacterial drugs for the inpatients increased from 1602. 85 yuan to 1888. 63 yuan,and AUD increased from 54. 50 DDDs/(100 persons × d) to 65. 47 DDDs/(100 persons × d). The sales amount proportion of antibacterial drugs for special use (13. 90%) was the lowest in 2013, and the highest (17. 34%) in 2015, and AUD increased from 4. 85 DDDs/(100 person × d)to 6. 37 DDDs/(100 person × d), and the submission rate of microbial specimen before the treatment increased from 85. 5% to 90. 0%. The main pathogenic bacteria were Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa and Acinetobacter baumannii,and their ratio had slight change. Except Staphylococcus aureus, the resistance rate of the other four pathogenic bacteria kept increasing, and the resistance rates of Acinetobacter baumannii to cefepime and carbapenems were over 50%. Conclusion:The approval process management of antibacterial drugs for special use must be strengthened in order to truly a-chieve reasonable use of antibacterial drugs for special use.
ABSTRACT
OBJECTIVE:To strengthen the supervision of clinical antibiotics use through establishing electronic consultation system. METHODS:Based on hospital information system(HIS)and antibiotic management system,consultation system for anti-biotics of special use(ASU)was established,and the effects of the system after used(Jan. 2014)were also evaluated. RESULTS:Real-time consultation of ASU medical orders and related consultation results inquiry and statistics could be achieved through de-signing ASU consultation application form,establishing consultation experts and confirming their working content,adding statistics function,etc. The consultation have been finished 8275 times from 2014 to 2015. The inspection rate for pathogenic microbes in ASU patients rose from 78.68% in 2013 to 83.90% in 2015. CONCLUSIONS:The establishment and application of ASU consulta-tion system can improve consultation efficiency and quality,so as to promote rational use of antibiotics in the clinic.
ABSTRACT
OBJECTIVE:To provide reference for rational utilization of antibiotics for special use. METHODS:Medical orders of antibiotics for special use in clinical departments of our hospital during 2013 to 2015 were selected from hospital information sys-tem. The consumption sum and its ratio,DDDs,DDC,DUI and the utilization of antibiotics for special use in clinical departments were calculated and analyzed. RESULTS:The consumption sum and its ratio of antibiotics for special use in our hospital during 2013 to 2015 both reduced year by year,decreasing from 21 872 200 yuan(48.00%)to 20 877 700 yuan(39.41%). The consump-tion sum ratio of carbapenems,cephalosporins and anti-deep fungal drugs showed descending tendency. The consumption sum ratio of anti-MRSA antibiotics changed slightly. DDDs of Meropenem for injection always took up the first place in recent 3 years,but the values were decreasing. DUI of Imipenem and cilastain sodium for injection was far less than 1,while those of Panipenem and betamipron for injection,Cefepime sodium for injection and Caspofungin acetate for injection(70 mg/injection)were far more than 1. The types of drug with DUI ranged 0.9-1.1 increased year by year,increasing from 3 types in 2013 (18.75%) to 10 types in 2015 (62.50%). Within 3 years, the utilization ratio of antibiotics for special use always took up the first place in ICU (86.64%-87.78%). CONCLUSIONS:The consumption sum and its ratio of antibiotics for special use in our hospital during 2013 to 2015 decreased year by year,and the utilization of antibiotics for special use become increasingly rational. But,there still are some problems,such as inadequate dose of Imipenem and cilastain sodium for injection,overdose of Panipenem and betamipron for injection,Cefepime sodium for injection and Caspofungin acetate for injection(70 mg/injection).
ABSTRACT
Objective To analyze the utilization of antibiotics for special use in our hospital in order to provide references for rational use antibiotics in clinic .Methods The utilization of antibiotics for special use in our hospital from 2010 to 2011 was analyzed with defined daily dose (DDD), consumption sum, DDC, DDDs and B/A as indexes.Results 72.22%of antibiotics for special use had been used in our hospital , main in injection .The changes of consumption sum , DDDs and proportion , DDC of antibiotics for spe-cial use varied from each other .The ratio of B to A of antibiotics for special use was in a range of 0.29~9.00.Conclusion The per-formance of stratified management of antibiotics did not implement exactly .It was necessary to strictly control the introduction , intensify education of medication and rigorously implement the performance of stratified management of antibiotics .
ABSTRACT
OBJECTIVE: To analyze utilization of antibiotics for special use in medical institution in order to provide reference of reducing incidence of ADR and avoiding rapid occurrence of bacterium. METHODS: The utilization of antibiotics for special use in our province from Jan. 2005 to Jun. 2008 was analyzed with DDD and DDDs as index. RESULTS&CONCLUSION: The changes of DDDs, cost order and proportion of antibiotics for special use were different from each other. The ratio of order of cost to order of DDDs of antibiotics for special use was between 0.33～5.00 and 72.22% of antibiotics for special use were widely used in different grades of medical institutions. Therefore, it is necessary to strictly control the introduction and utilization which meet requirement. Drug resistance rate of some antimicrobials for special use is up to 100%. So the relevant measure should be taken such as withdrawal of antibotics, monitor of drug resistance and establishment of warning system. Considering a certain degree of abuse, strict measure should be adopted in the primary medical institutions.