我国抗菌药使用强度持续下降

    发布时间:2019-04-15   来源:中华康网   
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4月12日,国家卫生健康委发布《中国抗菌药物管理和细菌耐药现状报告》(2016~2018年)。《报告》指出,我国抗菌药物使用总强度持续下降,但特殊使用级抗菌药物管理仍需加强重视,碳青霉烯类药物的消耗量等指标持续上升,临床选用抗菌药物品种过于集中,个别药物消耗量长期居于前列。

《报告》显示,截至2017年9月30日,全国抗菌药物临床应用监测网共有入网单位2860家。2017年全部入网单位中,抗菌药物占药品总收入的比例从2011年的15.1%下降到2017年的11.1%,总体呈下降趋势。中心成员单位的住院患者抗菌药物使用率也在明显下降,从2011年的59.4%下降到2017年的36.9%。另外,2017年消耗量排名第一的抗菌药物为喹诺酮类药物,消耗量排名前3位的抗菌药物品种分别是左氧氟沙星、头孢哌酮/舒巴坦和头孢呋辛,3种药物使用量的总体构成比为20.13%。

在细菌耐药趋势控制方面,碳青霉烯耐药肺炎克雷伯菌2017年检出率最高的地区超过25.0%,而且近5年这些地区的检出率持续上升。《报告》建议,应对检出率较高及持续增加的地区,加强相关应用管理及医院感染防控。《报告》指出,全国医院感染监测网各省医院感染现患率2016年为1.54%~5.93%。

《报告》指出,抗菌药物临床应用和耐药形势控制目前存在地区间、医疗机构间发展不平衡等问题,建议逐步转变抗菌药物临床应用管理模式,从“以行政部门干预为主”转变为“以多学科专业协作管理为主”,将细菌真菌感染诊疗能力的建设情况纳入抗菌药物管理评价指标,鼓励有条件的地区在三级综合医院实行含酶抑制剂复合制剂的专档管理。同时,要合理确定不同科室、不同处方权限医师数量,不得将抗菌药物处方权限作为身份地位象征、权力象征授予无关人员。

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