2022年全国抗菌药物临床应用专项整治行动方案.pdf

1 2011 年全国抗菌药物临床应用专项整治活动方案为进一步加强医疗机构抗菌药物临床应用管理，促进抗菌药物合理使用，有效控制细菌耐药，保证医疗质量和医疗安全，按照2011 年全国卫生工作会议和全国医疗管理工作会议要求，根据卫生部、国家食品药品监督管理局、工业和信息化部及农业部全国抗菌药物联合整治工作方案（卫医政发,2010?111 号）、2011 年“医疗质量万里行”活动方案（卫医政发,2011?号）和卫生部关于在全国医疗卫生系统开展“三好一满意”活动的通知（卫医政发,2011?号）要求，制定本方案。一、指导思想深入贯彻落实深化医药卫生体制改革工作要求，以科学发展观为指导，坚持“标本兼治、重在治本”的原则，按照“突出重点、集中治理、健全机制、持续改进”的工作思路，将抗菌药物临床应用专项整治活动作为“医疗质量万里行”和“三好一满意”活动的重要内容，统一部署、统一安排、统一组织、统一实施，围绕抗菌药物临床应用中的突出问题和关键环节进行集中治理，务求实效。完善抗菌药物临床应用管理长效工作机制，提高抗菌药物临床合理应用水平，保障患者合法权益和用药安全，实现为人民群众提供安全、有2 效、方便、价廉的医疗服务的医改目标。二、活动目标通过开展全国抗菌药物临床应用专项整治活动，进一步加强抗菌药物临床应用管理，优化抗菌药物临床应用结构，提高抗菌药物临床合理应用水平，规范抗菌药物临床应用，有效遏制细菌耐药；针对抗菌药物临床应用中存在的突出问题，采取标本兼治的措施加以解决；完善抗菌药物临床应用管理有效措施和长效工作机制，促进抗菌药物临床合理应用能力和管理水平持续改进。三、活动范围全国各级各类医疗机构，重点是二级以上公立医院。四、组织管理卫生部负责制定全国抗菌药物临床应用专项整治活动方案，并组织实施，组织对全国抗菌药物临床应用专项整治活动开展情况进行督导检查。各省级卫生行政部门负责制定本辖区抗菌药物临床应用专项整治活动工作方案，具体负责本辖区内抗菌药物临床应用专项整治活动的组织实施，督促本辖区医疗机构实现抗菌药物临床合理应用各项指标。医疗机构负责落实卫生部和省级卫生行政部门制定的各项工作措施，实现抗菌药物临床合理应用各项指标。医疗机构负责人是抗菌药物临床合理应用的第一责任人。文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z83 五、重点内容（一）明确抗菌药物临床应用管理责任制。医疗机构负责人是抗菌药物临床应用管理第一责任人，将抗菌药物临床应用管理作为医疗质量和医院管理的重要内容纳入工作安排；明确抗菌药物临床应用管理组织机构，层层落实责任制，建立、健全抗菌药物临床应用管理工作制度和监督管理机制。卫生行政部门与医疗机构负责人、医疗机构负责人与临床科室负责人分别签订抗菌药物合理应用责任状，明确抗菌药物合理应用控制指标。卫生行政部门和医疗机构把抗菌药物合理应用情况作为院长、科室主任综合目标考核以及晋升、评先评优的重要指标。卫生部和省级卫生行政部门将抗菌药物临床应用情况纳入医院评审、评价和临床重点专科建设指标体系，提高指标权重。（二）开展抗菌药物临床应用基本情况调查。医疗机构对院、科两级抗菌药物临床应用情况开展调查：抗菌药物品种、剂型、规格、使用量、金额，使用量排名前10 位的抗菌药物品种，住院患者抗菌药物使用率、使用强度、I 类切口手术和介入治疗抗菌药物预防使用率，门诊抗菌药物处方比例。（三）建立完善抗菌药物临床应用技术支撑体系。二级以上医院设置感染性疾病科和临床微生物室，配备感染专业文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z84 医师、微生物检验专业技术人员和临床药师，在抗菌药物临床应用中发挥重要作用，为医师提供抗菌药物临床应用相关专业培训，对临床科室抗菌药物临床应用进行技术指导，参与抗菌药物临床应用管理工作。（四）严格落实抗菌药物分级管理制度。医师经过抗菌药物临床应用培训并考核合格后，授予相应级别的抗菌药物处方权；医疗机构明确本机构抗菌药物分级目录，对不同管理级别的抗菌药物处方权进行严格限定，明确各级医师使用抗菌药物的处方权限；按照抗菌药物临床应用指导原则，有明确的限制使用抗菌药物和特殊使用抗菌药物临床应用程序，并能严格执行。（五）加强抗菌药物购用管理。医疗机构对抗菌药物目录进行全面梳理，清退存在安全隐患、疗效不确定、耐药严重、性价比差和违规促销的抗菌药物品种；严格控制抗菌药物购用品规数量，三级医院抗菌药物品种原则上不超过50种，二级医院抗菌药物品种原则上不超过35 种，同一通用名称注射剂型和口服剂型各不超过2 种，处方组成类同的复方制剂 1-2 种；三代及四代头孢菌素（含复方制剂）类抗菌药物口服剂型不超过5 个品规，注射剂型不超过8 个品规，碳青霉烯类抗菌药物注射剂型不超过3 个品规，氟喹诺酮类抗菌药物口服剂型和注射剂型各不超过4 个品规，深部抗真菌类抗菌药物不超过5 个品规。医疗机构抗菌药物采购目录（包括采购抗菌药物的品种、剂型和规格）要向核发其医文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z85 疗机构执业许可证的卫生行政部门备案。医疗机构确因临床工作需要，需采购的抗菌药物品种、规格超过上述规定，经备案的卫生行政部门审核同意后，向省级卫生行政部门提出申请，并详细说明理由。由省级卫生行政部门核准其申请抗菌药物的品种、规格的数量和种类。因特殊感染患者治疗需求，医疗机构需使用本机构采购目录以外抗菌药物的，可以启动临时采购程序。临时采购由临床科室提出申请，说明申请购入抗菌药物名称、剂型、规格、数量、使用对象和使用理由，经本机构药事管理与药物治疗学委员会抗菌药物管理工作组讨论通过后，由药学部门临时一次性购入使用。同一通用名抗菌药物品种启动临时采购程序不得超过5 次。如果超过5 次，要讨论是否列入本机构抗菌药物采购目录。调整后的采购目录抗菌药物总品种数不得增加。（六）抗菌药物使用率和使用强度控制在合理范围内。医疗机构住院患者抗菌药物使用率不超过60%，门诊患者抗菌药物处方比例不超过20%，抗菌药物使用强度力争控制在40DDD以下；I类切口手术患者预防使用抗菌药物比例不超过 30%；住院患者外科手术预防使用抗菌药物时间控制在术前 30 分钟至 2 小时，I 类切口手术患者预防使用抗菌药物时间不超过 24 小时。（七）定期开展抗菌药物临床应用监测与评估。医疗机构定期开展抗菌药物临床应用监测，有条件的医院利用信息文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z86 化手段加强抗菌药物临床应用监测；分析本机构及临床各专业科室抗菌药物使用情况，评估抗菌药物使用适宜性；对抗菌药物使用趋势进行分析，出现使用量异常增长、使用量排名半年以上居于前列且频繁超适应证超剂量使用、企业违规销售以及频繁发生药物严重不良反应等情况，及时采取有效干预措施。（八）加强临床微生物标本检测和细菌耐药监测。二级以上医院根据临床微生物标本检测结果合理选用抗菌药物，接受抗菌药物治疗住院患者微生物检验样本送检率不低于30%；开展细菌耐药监测工作，定期发布细菌耐药信息，建立细菌耐药预警机制，针对不同的细菌耐药水平采取相应应对措施；医疗机构按照要求向全国抗菌药物临床应用监测网报送抗菌药物临床应用相关数据信息，向全国细菌耐药监测网报送耐药菌分布和耐药情况等相关信息。（九）严格医师和药师资质管理。医疗机构对执业医师和药师进行抗菌药物相关专业知识和规范化管理培训；经过培训并考核合格后，授予相应的抗菌药物处方权或调剂资格。（十）落实抗菌药物处方点评制度。医疗机构组织感染、药学等相关专业技术人员对抗菌药物处方、医嘱实施专项点评。每个月组织对25%的具有抗菌药物处方权医师所开具的处方、医嘱进行点评，每名医师不少于50 份处方、医嘱，重点抽查感染科、外科、呼吸科、重症医学科等临床科室以文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z87 及 I 类切口手术和介入治疗病例。医疗机构根据点评结果，对合理使用抗菌药物前10 名的医师，向全院公示；对不合理使用抗菌药物前10 名的医师，在全院范围内进行通报。点评结果作为科室和医务人员绩效考核重要依据。对出现抗菌药物超常处方3 次以上且无正当理由的医师提出警告，限制其特殊使用级和限制使用级抗菌药物处方权；限制处方权后，仍连续出现2 次以上超常处方且无正当理由的，取消其抗菌药物处方权。（十一）建立省级抗菌药物临床应用和细菌耐药监测网。省级卫生行政部门建立本辖区抗菌药物临床应用监测网和细菌耐药监测网，与全国抗菌药物临床应用监测网和细菌耐药监测网互联互通；定期公布本辖区抗菌药物临床应用情况和细菌耐药监测情况，督促和指导本辖区医疗机构合理应用抗菌药物。（十二）建立抗菌药物临床应用情况通报和诫勉谈话制度。卫生部和省级卫生行政部门根据监测情况对医疗机构抗菌药物使用量、使用率和使用强度进行排序，对于未达到相关目标要求并存在严重问题的，召集医疗机构第一责任人诫勉谈话，并将有关结果予以通报。（十三）严肃查处抗菌药物不合理使用情况。卫生行政部门按照执业医师法、药品管理法、医疗机构管理条例等法律法规，加大对抗菌药物不合理使用的查处力度。文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 HT2X3U6W2R9 ZX1P10H1Z1Z8文档编码:CA4K2C1L10N8 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