I. The utilization rate of antimicrobial drugs
1. Percentage of outpatient use of antimicrobial drugs
Purpose: to examine the use of antimicrobial drugs in outpatient clinics.
Outpatient use of antimicrobial drugs: refers to the use of antimicrobial drugs, regardless of their use of several antimicrobial drugs, i.e., a patient registered once for a consultation with antimicrobial drugs, it is counted as: the use of antimicrobial drugs in the clinic for 1
Total visits during the same period: refers to the total number of visits of the patient in the same sampling time period, i.e., the number of patients who have registered in the same sampling time period <
Statistics: divide the number of cases of antimicrobial use per visit by the total number of visits multiplied by 100.
2. Use of antimicrobials in hospitalized patients
Purpose: to measure the use of antimicrobials in hospitalized patients
This item is calculated by the number of cases of antimicrobial use in the patient, and only counts the use of antimicrobials, no matter how many antimicrobials are used in a single case, including different dosage forms, and only counts the number of patients using the antimicrobial drugs. No matter how many antimicrobial drugs (including different dosage forms) are used in a case, it is only counted as one case of antimicrobial drug use.
If the group (surgical, non-surgical or prophylactic, therapeutic) calculation, the total number of discharges in the same period is not the same, the weight should be considered.
II. Number of antimicrobial items per inpatient
Purpose: To measure the average number of antimicrobials used per inpatient using antimicrobials.
Discharged patients: since inpatient medication use did not stop during the sampling period and could not be calculated, the data related to patients discharged during the same period were used for statistical purposes.
Simultaneous: the total number of discharges using antimicrobial drugs during a sampling time period.
Clarify the range of antimicrobial drugs.
Number of antimicrobial articles: statistics by generic name of antimicrobial drugs.
Statistics: total number of varieties of antimicrobial drugs used by all discharged patients during the sampling period divided by the use of antimicrobial drugs during the same period
III. Per capita cost of antimicrobial drugs used in hospitalized patients
Objective: to measure the average cost of antimicrobial drugs used during the hospitalization of patients
Discharged patients: because during the sampling period, the use of medication in hospitalized patients did not stop, and it was impossible to calculate, so it was used the data related to the same period of patients discharged from the hospital for statistical purposes.
Simultaneous: the total number of discharges using antimicrobial drugs during a sampling time period.
The cost of antimicrobial drugs was based on the most recent purchase price of the drug (priced by trade name).
Statistics: total cost of antimicrobial drugs used by all discharged patients during the sampling period divided by the total number of cases using antimicrobial drugs during the same period
IV. Intensity of antimicrobial use
Intensity of antimicrobial use: is the number of DDDs of antimicrobial drugs consumed per 100 person days.
DDD value: calculated in accordance with the WHO recommendation of drug application daily prescription agreed dose: (defined daily doses , DDD), the same generic name of the drug dosage form different DDD value is different.
The number of DDD for a particular antimicrobial drug = the amount of the antimicrobial drug consumed divided by the DDD value (grams/DDD value).
Antimicrobial drug consumption (cumulative DDD number) = sum of DDD numbers of all antimicrobial drugs.
Patient person days admitted: the product of the total number of patients discharged during the same sampling time period and the average number of patient days in the hospital during the same period.
Because of the variation in dosage of different antimicrobial drugs, it is important to establish a metric that can be used for comparisons between different drugs.One such metric is the number of DDDs (Defined Daily Dose).DDD (Defined Daily Dose) refers to the average daily dose of a drug that is used in adults in order to achieve the primary use of the drug.
There are two ways of calculating the DDD number(1)
1. DDDs = (Annual Consumption of a Drug x 1000)/(DDD Value x 365 Days x Number of Inhabitants)
Meaning: the amount of a particular drug consumed per day per 1,000 inhabitants, as measured by the Agreed Daily Dose. It is applicable to the overall evaluation of the use of medicines by residents in a certain area.
2. DDDs=Annual consumption of a drug/DDD value
Meaning: the amount of a drug consumed in terms of an agreed daily dose. Applicable to a hospital or several hospitals in different years of dynamic comparison and analysis of the drug structure.
The DDD number is used as a comparable indicator between different drugs because the DDD number is a ratio, a value independent of the daily dose, and is not incomparable because of the different dosages of various drugs at one time and the number of times a day they are used. a large DDD number reflects a large tendency to choose the drug, and vice versa, a gradual decrease in the use of the drug.
The DDD takes the usual daily dose for adults as the standard dose and converts the consumption of different drugs into a uniform standard unit. The World Health Organization recommends DDD as an indicator of the rationality of drug use in research and has issued standard DDD values for each antibiotic used to standardize such research.
Cumulative DDD or average DDD can be calculated for a single case or for all cases of drug use, as well as cumulative DDD for the use of different types of drugs.
V. Antimicrobial drug costs as a percentage of total drug costs
Purpose: to measure the relative value of antimicrobial drug costs to total drug costs
Statistics: divide the total amount of antimicrobial drugs that have been used by the total amount of drugs that have been used times 100.
VI. Percentage of special-use varieties of antimicrobial drugs used in antimicrobial drug use
Objective: to measure the relative value of special-use classes of antimicrobial drugs in the total amount of antimicrobial drugs used
Statistics: divide the amount of special-use classes of antimicrobial drugs used (cumulative number of DDDs) by total amount of antimicrobial drugs used (cumulative number of DDDs) multiplied by 100.
VII. Percentage of patients hospitalized with antimicrobials for pathogenetic testing
Objective: to measure the ability to provide pathogenetic testing to determine the optimal treatment regimen.
Hospitalized antimicrobial drug patients: are patients on therapeutic antimicrobial drugs.
Statistics: the number of hospitalized cases for which pathogenetic testing was done divided by the number of hospitalized cases for which therapeutic antimicrobials were used during the same period multiplied by 100.
VIII. Percentage of antimicrobial drugs for prophylaxis in clean surgery
Purpose: to measure the level of prophylactic use in clean surgery cases
Number of cases of antimicrobial drugs for prophylaxis in clean surgery: only refers to clean surgery cases used for prophylaxis
Total number of cases of clean surgery in the same period: it is a statistic based on the number of cases of clean surgery
IX. Days of antimicrobials per capita for prophylaxis in clean surgery
Purpose: to measure the extent of prophylactic use in clean surgery cases
Total days of antimicrobials for prophylaxis in clean surgery: is the total number of days of antimicrobials used in clean surgery cases for prophylaxis only.
Total number of antimicrobial drugs used for clean surgical cases in the same period: it is the number of cases of antimicrobial drugs used for clean surgical cases.
IX. Percentage of those who underwent clean surgery, administered within 0.5-2.0 hours preoperatively
Objective: to examine the reasonable rate of the first prophylactic use of antimicrobial drugs in the preoperative period for clean surgery
Because according to the guidelines for the clinical application of antimicrobial drugs and the relevant management regulations, it is reasonable to administer drugs for the prevention of incisional infections in clean surgery within 0.5-2.0 hours prior to the incision of the skin, in general .
This item is all based on the number of cases.
Antimicrobial drug use rate and intensity of use:
Antimicrobial drug use rate of inpatients in medical institutions does not exceed 60%,
The proportion of antimicrobial drug prescriptions for outpatients does not exceed 20%,
Antimicrobial drug intensity of use is striving to control the use of antimicrobial drugs at less than 40DDD;
The proportion of antimicrobial drug use in prophylactic use of patients with Class I incision surgery does not exceed 30%;
The proportion of patients with Class I incision surgery is not more than 30%;