Qom University of Medical Sciences Journal
مجله دانشگاه علوم پزشکی قم
Qom Univ Med Sci J
Medical Sciences
http://journal.muq.ac.ir
1
admin
1735-7799
2008-1375
10.32598/QUSMJ
en
jalali
1399
4
1
gregorian
2020
7
1
14
5
online
1
fulltext
fa
بررسی وضعیت تجویز آنتیبیوتیکها در بیمارستانهای استان قم، سال 1397
Investigation on the States of Antibiotics Prescription in Hospitals in Qom, Iran, during 2019
فارماکولوژی
pharmacology
مقاله پژوهشي
Original Article
<strong><span style="font-family:b zar;"><span style="font-size:11.5pt;">زمینه و هدف: </span></span></strong><span style="font-family:b zar;"><span style="font-size:11.5pt;">مصرف غیرمنطقی آنتیبیوتیک</span></span><span dir="LTR"><span style="font-size:11.5pt;"></span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">ها به افزایش مقاومت دارویی منجر میشود.</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">سیستم شیمیایی درمانی آناتومیک / دز مشخص روزانه</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">(</span></span><span dir="LTR"><span style="font-size:10.0pt;">ATC/DDD:</span></span><span dir="LTR"><span style="font-size:10.0pt;"> Anatomical Therapeutic Chemical/Defined Daily Dose</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">) ابزاری برای نظارت بر استفاده و تحقیق در زمینه بهبود کیفیت مصرف داروها و مقایسه آمار مصرف دارو در سطح بین</span></span><span dir="LTR"><span style="font-size:11.5pt;"></span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">الملل و سطوح دیگر است. مطالعه حاضر با هدف تعیین وضعیت تجویز آنتی</span></span><span dir="LTR"><span style="font-family:cambria,serif;"><span style="font-size:11.5pt;"></span></span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">بیوتیک در بیمارستان</span></span><span dir="LTR"><span style="font-size:11.5pt;"></span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">های شهر قم انجام شده است.</span></span><br>
<strong><span style="letter-spacing:-.15pt;"><span style="font-family:b zar;"><span style="font-size:11.5pt;">روش بررسی:</span></span></span></strong> <span style="font-family:b zar;"><span style="font-size:11.5pt;">این مطالعه مقطعی روی 1200 پرونده بیماران با روش نمونه</span></span><span dir="LTR"><span style="font-size:11.5pt;"></span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">گیری چندمرحله</span></span><span dir="LTR"><span style="font-size:11.5pt;"></span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">ای در سال 1397 انجام شد. برای جمع</span></span><span dir="LTR"><span style="font-size:11.5pt;"></span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">آوری داده از پرسشنامه محقق</span></span><span dir="LTR"><span style="font-size:11.5pt;"></span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">ساخته شامل اطلاعات دموگرافیک و آنتیبیوتیک</span></span><span dir="LTR"><span style="font-size:11.5pt;"></span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">های مصرفی بیماران و سیستم </span></span><span dir="LTR"><span style="font-size:10.0pt;">ATC/DDD</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">بر اساس شاخص </span></span><span dir="LTR"><span style="font-size:10.0pt;">DDD/100bed−days</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">استفاده شد. اطلاعات با استفاده از نرمافزار </span></span><span dir="LTR"><span style="font-size:10.0pt;">SPSS</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">ورژن 20، آمار توصیفی و آزمون تحلیل واریانس</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">تجزیهوتحلیل شد.</span></span><br>
<strong><span style="letter-spacing:-.1pt;"><span style="font-family:b zar;"><span style="font-size:11.5pt;">یافتهها:</span></span></span></strong> <span style="font-family:b zar;"><span style="font-size:11.5pt;">نتایج نشان میدهد </span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">میزان آنتیبیوتیکهای تجویزشده با فصل بستری بیماران ارتباط معنیداری نداشت (</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">5</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">/</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">0</span></span><span style="font-size:10.0pt;"><</span><span dir="LTR"><span style="font-size:10.0pt;">P</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">). </span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">بیشتر آنتیبیوتیک</span></span><span dir="LTR"><span style="font-size:11.5pt;"></span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">ها بهشکل تزریقی (</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">5</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">/</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">93</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">درصد) توسط متخصصان جراحی (</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">70</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">/</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">50</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">درصد) تجویز شده بود. بیمارستان</span></span><span dir="LTR"><span style="font-size:11.5pt;"></span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">های زنان و زایمان بیشترین (</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">4</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">/</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">18</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;"> درصد) و کودکان کمترین (</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">4</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">/</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">12</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;"> درصد) تجویز آنتیبیوتیک را داشتند. </span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">دُز روزانه تجویزشده بهازای هر 100 روز تخت اشغالی برای</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">شایعترین آنتیبیوتیکهای مصرفی آمیکاسین </span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">18</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">/</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">21</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">، سفتریاکسون </span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">62</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">/</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">33</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">، آمپیسیلین </span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">34</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">/</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">19</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">، مروپنم </span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">10</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">/</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">6</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">و ونکومایسین </span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">28</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">/</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">11</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">بود.</span></span><br>
<strong><span style="font-family:b zar;"><span style="font-size:11.5pt;">نتیجهگیری:</span></span></strong> <span style="font-family:b zar;"><span style="font-size:11.5pt;">نتایج نشان میدهد</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">پنج آنتیبیوتیک آمیکاسین، سفتریاکسون، آمپیسیلین، مروپنم و ونکومایسین شایعترین آنتیبیوتیک مصرفی در مطالعه حاضر بود که بیش از </span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">70</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;"> درصد از کل آنتی</span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;"></span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">بیوتیک</span></span><span dir="LTR"><span style="font-size:11.5pt;"></span></span><span style="font-family:b zar;"><span style="font-size:11.5pt;">های تجویزی را به خود اختصاص دادند و</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">شاخص </span></span><span dir="LTR"><span style="font-size:10.0pt;">DDD/100bed−days</span></span> <span style="font-family:b zar;"><span style="font-size:11.5pt;">شایعترین آنتیبیوتیکهای مصرفی از شاخص گزارششده سازمان جهانی بهداشت بیشتر بود.</span></span>
<strong><em>Background and Objectives:</em></strong> Irrational use of antibiotics can lead to increased drug resistance. The Anatomical Therapeutic Chemical/ Defined Daily Dose (ATC/DDD) system is a tool to monitor medication use, evaluate the improvements in drug consumption quality, and make comparisons between international and other levels in this regard. This study aimed to determine the status of antibiotic prescription in hospitals in Qom, Iran.<br>
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<strong><em>Methods:</em></strong> This cross-sectional study was performed on 1200 medical records of the patients using a multi-stage sampling method in 2019. The data were collected through a researcher-made questionnaire to seek demographic information and antibiotics used by patients, as well as ATC/DDD based on the DDD/100 bed-days index. Furthermore, the data were analyzed in SPSS software (version 20) through descriptive statistics and analysis of variance.<br>
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<strong><em>Results:</em></strong> The results showed no significant relationship between the number of prescribed antibiotics and the hospitalization season (P>0.05). The majority of the antibiotics were injectable (93.5%) prescribed by surgical specialists (50.70%). Gynecology and Children's hospitals obtained the highest (18.4%) and the least (12.4%) level of antibiotic prescription, respectively. The daily recommended doses for every 100 days of bed rest for the most common antibiotics were Amikacin (21.81), Ceftriaxone (33. 62), Ampicillin (19. 34), Meropenem (6.10), and Vancomycin (11<span dir="RTL">.</span>28).<br>
<pre>
<strong><em>Conclusion:</em></strong> The results show that Amikacin, Ceftriaxone, Ampicillin, Meropenem, and Vancomycin were the most common antibiotics used in the present study accounting for more than 70% of the total antibiotics administered. The DDD/100 bed-days of the most commonly used antibiotics were higher than those reported by the World Health Organization.</pre>
سیستم طبقهبندی تشریحی-درمانی-شیمیایی, عوامل ضد باکتریایی, کاربرد درمانی, بیمارستان ها
Anatomical Therapeutic Chemical Classification System, Anti-Bacterial Agents, Hospitals, Therapeutic Use.
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21
http://journal.muq.ac.ir/browse.php?a_code=A-10-1976-1&slc_lang=fa&sid=1
Elham
Golfeshan
الهام
گلفشان
elham.gol93@gmail.com