Hierarchical management of antibacterial drugs:

1. "Unrestricted use" drugs (i.e. first-choice drugs, first-line drugs): good efficacy, small side effects, low bacterial resistance, and low price Antibacterial drugs can be selected by clinical physicians at all levels according to their needs.

2. "Restricted use" drugs (i.e., second-choice drugs, second-line drugs): drugs that are effective but expensive or have certain limitations in toxic side effects and bacterial resistance. The reasons for their use must be explained. It can only be used with the consent and signature of the attending physician or above.

3. "Special use drugs" (i.e. third-line drugs): good efficacy, expensive, there is still little clinical data on the efficacy or safety of special drug-resistant bacteria or newly launched antibacterial drugs, or clinical needs Drugs that are designed to double protect bacteria from developing drug resistance too quickly should have strict indications or solid basis for use. They must be consulted by relevant experts or approved by the undergraduate director, and their prescriptions must be signed by the deputy director and chief physician before they can be used.

4. Our hospital’s “Antimicrobial Drug Hierarchical Management Catalog” covers all antibacterial drugs. When new drugs are introduced, their hierarchical management levels should be clarified at the same time.

(1) The Pharmaceutical Affairs Management Committee, Pharmacy Department and Medical Department regularly carry out training and education on rational drug use, and supervise the clinical rational use of drugs in our hospital; in accordance with the "Guiding Principles" and "Implementation Rules", regular and irregular Regularly supervise and inspect the use of antibacterial drugs in various departments, and provide correction and improvement suggestions for irrational drug use.

(2) Incorporate the rational use of antimicrobial drugs into the medical quality inspection content and the department’s comprehensive target management assessment system.

(3) Inspection and assessment methods: Regular random inspections of outpatient and emergency prescriptions, inpatient medical records, including the preventive use of antibacterial drugs in surgical patients.

1. Key points for the examination and assessment of antimicrobial drugs in outpatient clinics and emergency rooms: write down the patient’s basic information, including age, gender, and diagnosis; use of antimicrobial drugs, including name, specifications, usage, dosage, route of administration, and whether The hierarchical management of antibacterial drugs regulates the use of drugs, etc.

2. Key points for the examination and assessment of antimicrobial drugs for inpatients:

(1) Whether the reasons are analyzed and explained when antimicrobial drugs are started, stopped, changed varieties, or used beyond the scope of the instructions, and whether It is recorded in the disease course record;

(2) The use of antibacterial drugs must comply with the regulations on the hierarchical management of antibacterial drugs. When used beyond the level, whether it is used according to the prescribed time or the corresponding procedures are performed, and it is recorded in the disease course record. reflected;

(3) Whether there are indications for the combination or local application of antibacterial drugs, whether there is an analysis, and it is recorded in the disease course record;

(4) Use or Whether pathogen detection and drug susceptibility testing are done before changing antibacterial drugs, and whether they are reflected in the disease course record; for cases that cannot be submitted for examination, whether the reasons have been explained in the disease course record.

(4) The hospital will report and criticize departments and individuals who abuse antimicrobial drugs in violation of regulations. In serious cases, the authority to use antimicrobial drugs will be reduced or even the prescription authority will be suspended.

Legal basis: Article 3 of the "Notice of the General Office of the Ministry of Health on Further Strengthening the Management of Clinical Application of Antimicrobial Drugs" strictly follows the provisions of the hierarchical management system of antimicrobial drugs and strengthens the management of clinical application of antimicrobial drugs.

Pharmaceutical management committees of medical institutions should effectively perform their functions of guiding the rational use of drugs in their institutions, carry out clinical pharmacy work with rational drug use as the core, and strengthen education, training and supervision of the rational use of antibacterial drugs for medical staff. Work, according to the "non-restricted use", "restricted use" and "special use" hierarchical management regulations, establish and improve the hierarchical management system of antimicrobial drugs, clarify the prescription authority of doctors to use antibacterial drugs, and prevent and correct the phenomenon of irrational use of antibacterial drugs.