抗菌药物使用管理制度

抗菌药物使用 管理制度 档案管理制度下载食品安全管理制度下载三类维修管理制度下载财务管理制度免费下载安全设施管理制度下载 为了加强抗生素使用管理～降低感染发生率～减少耐药性细菌的产生～促进抗生素的合理应用。特作以下 规定 关于下班后关闭电源的规定党章中关于入党时间的规定公务员考核规定下载规定办法文件下载宁波关于闷顶的规定 : 一、成立合理使用抗生素管理小组～成员由临床科室主任～医务科主任、药剂科主任、检验科主任等参加。 二、该小组负责拟订抗生素使用规定～组织药剂科和检验部门定期检查～根据药房反馈信息～调研和分析全院抗生素使用情况～并对存在问题提出改进措施。 三、检验科对各科送检的培养标本按要求做细菌培养、鉴定～并分科登记检验结果～定期上报,每季度一次,主要病原菌及其它真菌、病毒等感染情况～为临床合理使用抗生素提供信息。 四、药房应建立各类抗生素的出入消耗登记制度～将临床使用抗生素存在的问题及时反馈给合理使用抗生素管理小组。 五、各科主任应督促检查各级医师使用抗生素～应严格掌握抗生素使用的适应症和给药途径～遵照有效少量的原则～消除重复用药现象。住院总医师必须熟悉 管理办法 关于高温津贴发放的管理办法稽核管理办法下载并购贷款管理办法下载商业信用卡管理办法下载处方管理办法word下载 及使用规则～协助科主任做好此项工作～护士要了解各种抗生素的药理作用和配制要求～准确执行医嘱～并观察病人用药后的反应。 六、药事管理委员会制定并监督实施抗生素分线分级使quality egg, chicken, ... Development of poultry industry will occupy a certain area of land, there is a modern product with comprehensive rollup of 50,000 chickens laying hens, covers an area of 14.87 hectares (233 acres) more (including Office of hatching, brood rearing, and laying House, eggs, feed processing workshop, Office, etc). The poultry industry should work in land conservation, not accounted for or less cultivated land, wasteland, the principle of slope land. When the chicken farm should generally not available to local arable land area to determine an appropriate level of breeding size and not, as in the past, first determine the size, then go to the expropriation. 3. energy-saving, water-saving awareness in the 1970 of the 20th century, the pig and chicken farm mechanization in our country forward under the slogan, the country started building a modern large chicken farms in the climax. Was built as the fully enclosed intensive chicken farms, using artificial light, mechanical feeding and mandatory ventilation, a small number of chicken farms also use mechanical sets eggs and manure. According to statistics, fully enclosed chicken coop per chicken when the annual electricity consumption of 10-kilowatt •, half opened the henhouse when • 2~5 kW (open), when the entire opening is 0.5 kW •, rolling open sheds at 0.45 kW •. Hen house types, power consumption difference is very big, a difference of 10~20. China's energy supply is in short supply. Therefore, in determining the breeding, poultry equipment selection should take full consideration of energy saving issues. Lack of fresh water resources in China, the average annual precipitation is 600 mm. 1988 2474 cubic meters of water per capita in China, only 1/4 of the population all over the world, now reduced to 2300 cubic meters. Hen daily water intake to about 1.5~2 times, so when you 用 规范 编程规范下载gsp规范下载钢格栅规范下载警徽规范下载建设厅规范下载 。确定医院内抗生素的一、二、三线用药,一线药物,窄谱、疗效肯定、不良反应小、价格低廉、货源充足的抗菌药物,、二线药物,抗菌谱较广、疗效好但不良反应较明显或价格较贵的抗菌药物,、三线抗菌药物,疗效独特但毒性较大、价格昂贵、新研制上市的抗菌药物以及一旦发生耐药即会产生严重后果的抗菌药物～严格控制使用,～并对每线抗菌药物的使用权限作出相应规定～越线使用需经上级医生授权。一线用药需住院医师资格以上处方方可使用,二线用药应采取一定程度的限制措施～如规定处方量～规定临床选用的适应症～需经上一级医师,一般指主治医师以上,同意等并由临床药房监督,三线用药需具有副高以上职称医师方可使用。 抗生素合理使用的原则及参考规则 为保障患者能得到最佳疗效和最小毒、副反应的抗生素治疗～同时减少耐药性细菌而降低医院感染的发生率～特制定以下原则及相关规则: 一、合理使用抗生素的原则 1、有效控制感染～争取最佳疗效, 2、预防和减少抗生素的毒副作用, 3、注意剂量和疗程～避免产生耐药菌株, 4、密切注意病人体内正常菌群失调, 5、根据药敏试验～严格选药和给药途径～防止浪费。 so usensive chicken farms, using artificial light, mechanical feeding and mandatory ventilation, a small number of chicken farms alder the slogan, the country started building a modern large chicken farms in the climax. Was built as the fully enclosed intesaving awareness in the 1970 of the 20th century, the pig and chicken farm mechanization in our country forward un-saving, water-gyn appropriate level of breeding size and not, as in the past, first determine the size, then go to the expropriation. 3. enermine aeland, the principle of slope land. When the chicken farm should generally not available to local arable land area to deterorkshop, Office, etc). The poultry industry should work in land conservation, not accounted for or less cultivated land, wasting wan area of 14.87 hectares (233 acres) more (including Office of hatching, brood rearing, and laying House, eggs, feed process ill occupy a certain area of land, there is a modern product with comprehensive rollup of 50,000 chickens laying hens, coversquality egg, chicken, ... Development of poultry industry wout 1.5~2 times, so when youto abper capita in China, only 1/4 of the population all over the world, now reduced to 2300 cubic meters. Hen daily water intake g issues. Lack of fresh water resources in China, the average annual precipitation is 600 mm. 1988 2474 cubic meters of watersavin in short supply. Therefore, in determining the breeding, poultry equipment selection should take full consideration of energyeds at 0.45 kW •. Hen house types, power consumption difference is very big, a difference of 10~20. China's energy supply is kilowatt •, half opened the henhouse when • 2~5 kW (open), when the entire opening is 0.5 kW •, rolling open sh-consumption of 10 mechanical sets eggs and manure. According to statistics, fully enclosed chicken coop per chicken when the annual electricity 2 二、合理使用抗生素规则 1、 病毒性感染或病毒感染可能性较大的患者～一般不 使用抗生素。 2、 对发热原因不明～且无可疑细菌感染征象者、不宜使用抗生素。对病情严重或细菌性感染不能排除者～可针对性地选用抗生素～并密切注意病情变化～一旦确认非细菌性感染者～应立即停用抗生素。 3、 凡怀疑细菌感染的病例～应力争在使用抗生素前按疾病诊疗常规采集标 本,包括血、痰、尿、脓液～咽拭子及各种体腔标本等,、进行细菌培养。为提高病原菌培养阳性率～检验科在接到标本后应立即接种于特殊培养基～可采用对流免疫、荧光免疫、乳胶免疫、酶联免疫等新技术～对病原菌进行早期快速诊断。 4、 根据细菌学检查结果～结合临床选用敏感的抗生素～或对原来使用的抗生素进行必要的调整。选用抗生素同时要注意药品来源价格。 5、 联合使用抗生素应有严格的指征,一般适用于一种抗生素不能控制的严重感染、(包括败血症、细菌性心内膜、化脓性脑膜炎等)、混合感染、二重感染以及需要长期用药,而细菌容易产生耐药的病例～以两联为宜～但要合理掌握疗程～联合使用抗生素应能达到协同或相加的疗效～不增加毒副反应～防止和延缓耐药菌株产生的目的～ kilowatt •, -manure. According to statistics, fully enclosed chicken coop per chicken when the annual electricity consumption of 10icial light, mechanical feeding and mandatory ventilation, a small number of chicken farms also use mechanical sets eggs and artif y started building a modern large chicken farms in the climax. Was built as the fully enclosed intensive chicken farms, usings in the 1970 of the 20th century, the pig and chicken farm mechanization in our country forward under the slogan, the countrsaving awarenes-saving, water-eding size and not, as in the past, first determine the size, then go to the expropriation. 3. energynd. When the chicken farm should generally not available to local arable land area to determine an appropriate level of brepe lapoultry industry should work in land conservation, not accounted for or less cultivated land, wasteland, the principle of slo acres) more (including Office of hatching, brood rearing, and laying House, eggs, feed processing workshop, Office, etc). Thecomprehensive rollup of 50,000 chickens laying hens, covers an area of 14.87 hectares (233 quality egg, chicken, ... Development of poultry industry will occupy a certain area of land, there is a modern product with ouf the population all over the world, now reduced to 2300 cubic meters. Hen daily water intake to about 1.5~2 times, so when y1/4 o ter resources in China, the average annual precipitation is 600 mm. 1988 2474 cubic meters of water per capita in China, onlyetermining the breeding, poultry equipment selection should take full consideration of energy saving issues. Lack of fresh wa, in de types, power consumption difference is very big, a difference of 10~20. China's energy supply is in short supply. Thereforehalf opened the henhouse when • 2~5 kW (open), when the entire opening is 0.5 kW •, rolling open sheds at 0.45 kW •. Hen hous3 严格禁止无根据的随意联合用药。 6、 要避免外用青霉素类?头孢菌素及氨基糖甙类抗生素;对眼科～耳鼻喉科～外科?妇科及皮肤科使用的外用抗生素也应严格管理～掌握适应症～避免滥用。 7、 细菌性感染所致发热～经抗生素治疗体温正常～主要症状消失后～及时停用抗生素。但败血症骨髓炎、细菌性心内膜炎、化脓性脑膜炎、结核及某些重症感染可视情况而定。 8、 明确诊断的急性细菌性感染～在使用某种抗生素72小时后～临床效果不明显～或病情加重～应多方面分析原因。确属抗生素使用问题时～应调整剂量、给药途径或根据细菌培养及药敏试验结果～改用其它敏感性药物。 9、 一般情况不因预防目的而使用抗生素、特别是滥用广谱抗生素～对内科无感染征象的心血管病、脑血管意外、恶性肿瘤、糖尿病、非感染性休克、慢性肾脏疾患,一般不 应预防性使用抗生素。 10、 只有对急性风湿热,可定期使用青霉素G以杀灭咽 部溶血性链球菌。 11、所有胃肠道手术及胆囊手术除其它术前处理外～可 术前一小时给予抗生素预防治疗。 12、 对其它选择性手术,特别是心脏手术、矫形手术前一天开始使用抗生素、手术后使用时间根据病情决定。 eds at 0.45 kW •. Hen house types, power consumption difference is very big, a difference of 10~20. China's energy supply is kilowatt •, half opened the henhouse when • 2~5 kW (open), when the entire opening is 0.5 kW •, rolling open sh-consumption of 10 mechanical sets eggs and manure. According to statistics, fully enclosed chicken coop per chicken when the annual electricity so usensive chicken farms, using artificial light, mechanical feeding and mandatory ventilation, a small number of chicken farms alder the slogan, the country started building a modern large chicken farms in the climax. Was built as the fully enclosed intesaving awareness in the 1970 of the 20th century, the pig and chicken farm mechanization in our country forward un-saving, water-gyn appropriate level of breeding size and not, as in the past, first determine the size, then go to the expropriation. 3. enermine aeland, the principle of slope land. When the chicken farm should generally not available to local arable land area to deterorkshop, Office, etc). The poultry industry should work in land conservation, not accounted for or less cultivated land, wasting wan area of 14.87 hectares (233 acres) more (including Office of hatching, brood rearing, and laying House, eggs, feed process ill occupy a certain area of land, there is a modern product with comprehensive rollup of 50,000 chickens laying hens, coversquality egg, chicken, ... Development of poultry industry wout 1.5~2 times, so when youto abper capita in China, only 1/4 of the population all over the world, now reduced to 2300 cubic meters. Hen daily water intake g issues. Lack of fresh water resources in China, the average annual precipitation is 600 mm. 1988 2474 cubic meters of watersavin in short supply. Therefore, in determining the breeding, poultry equipment selection should take full consideration of energy4 13、 必须认识到人体免疫力的重要性～强调综合治疗～ 不要过分依赖抗菌药物。 三、抗菌药物过度使用进行干预的措施 ,一,抗菌药物临床应用分级管理 根据抗菌药物的特点、临床疗效、细菌耐药、不良反应及当地社会经济状况、药品价格等因素～将抗菌药物分为三级: •一级:非限制性使用抗菌药物:经临床长期应 用的安全有效、对细菌耐药影响小、价格相对较低的 药物。 ••二级:限制性使用抗菌药物:与一般药物相 比较～在临床疗效、不良反应、对细菌耐药性影响、 药品价格等方面存在一定的局限性～不宜作为非限制 使用的抗菌药物。 ...三级:特殊情况下使用的抗菌药物:指不良 反应明显、不宜随意使用或临床需要加倍保护以免细 菌过快产生耐药而导致严重后果的药物～或者属于新 上市的抗菌药物～其疗效或安全性无肯定 资料 新概念英语资料下载李居明饿命改运学pdf成本会计期末资料社会工作导论资料工程结算所需资料清单 ～或价 格十分昂贵。 ,二,加强抗菌药物合理使用监管 (1)、加强各科在抗生素合理使用方面的检查和培训～医院组织对全院医务人员进行了《抗菌药物临床应 icial light, mechanical feeding and mandatory ventilation, a small number of chicken farms also use mechanical sets eggs and artif y started building a modern large chicken farms in the climax. Was built as the fully enclosed intensive chicken farms, usings in the 1970 of the 20th century, the pig and chicken farm mechanization in our country forward under the slogan, the countrsaving awarenes-saving, water-eding size and not, as in the past, first determine the size, then go to the expropriation. 3. energynd. When the chicken farm should generally not available to local arable land area to determine an appropriate level of brepe lapoultry industry should work in land conservation, not accounted for or less cultivated land, wasteland, the principle of slo acres) more (including Office of hatching, brood rearing, and laying House, eggs, feed processing workshop, Office, etc). Thecomprehensive rollup of 50,000 chickens laying hens, covers an area of 14.87 hectares (233 quality egg, chicken, ... Development of poultry industry will occupy a certain area of land, there is a modern product with ouf the population all over the world, now reduced to 2300 cubic meters. Hen daily water intake to about 1.5~2 times, so when y1/4 o ter resources in China, the average annual precipitation is 600 mm. 1988 2474 cubic meters of water per capita in China, onlyetermining the breeding, poultry equipment selection should take full consideration of energy saving issues. Lack of fresh wa, in de types, power consumption difference is very big, a difference of 10~20. China's energy supply is in short supply. Thereforehalf opened the henhouse when • 2~5 kW (open), when the entire opening is 0.5 kW •, rolling open sheds at 0.45 kW •. Hen houskilowatt •, -manure. According to statistics, fully enclosed chicken coop per chicken when the annual electricity consumption of 105 用指导原则》、《处方管理办法》等规范的培训～同时将 这些规范列入院目标管理考核范围～定期对病区和门诊 的落实情况进行考核和抽查,及时通报检查情况。 (2)加强对医师合理用药的监管和考核～对于超权 限、不合理或滥用抗菌素及超过药占比的病区和个人通 报批评并给予相应处罚。 (3)、各科室每月使用药品超过医院规定的限度时～ 由经改办从科室当月奖金中按一定比例扣除～有效遏制 了临床抗生素的滥用现象。 ,三, 实施抗菌药物动态监测 统计全院抗菌药物应用总量占药品总数的百分率和抗菌药物应用数量及排序,从销售额和数量进行统计公布～前三名的抗菌药物采取必要的措施～并向全院发布用药通报。对规范医师用药行为、保障患者用药安全、提高临床治疗水平、减轻患者不合理医疗费用负担将具有积极的促进作用。 泸州市纳溪区丰乐镇卫生院 二0一二年九月十日 so usensive chicken farms, using artificial light, mechanical feeding and mandatory ventilation, a small number of chicken farms alder the slogan, the country started building a modern large chicken farms in the climax. Was built as the fully enclosed intesaving awareness in the 1970 of the 20th century, the pig and chicken farm mechanization in our country forward un-saving, water-gyn appropriate level of breeding size and not, as in the past, first determine the size, then go to the expropriation. 3. enermine aeland, the principle of slope land. When the chicken farm should generally not available to local arable land area to deterorkshop, Office, etc). The poultry industry should work in land conservation, not accounted for or less cultivated land, wasting wan area of 14.87 hectares (233 acres) more (including Office of hatching, brood rearing, and laying House, eggs, feed process ill occupy a certain area of land, there is a modern product with comprehensive rollup of 50,000 chickens laying hens, coversquality egg, chicken, ... Development of poultry industry wout 1.5~2 times, so when youto abper capita in China, only 1/4 of the population all over the world, now reduced to 2300 cubic meters. Hen daily water intake g issues. Lack of fresh water resources in China, the average annual precipitation is 600 mm. 1988 2474 cubic meters of watersavin in short supply. Therefore, in determining the breeding, poultry equipment selection should take full consideration of energyeds at 0.45 kW •. Hen house types, power consumption difference is very big, a difference of 10~20. China's energy supply is kilowatt •, half opened the henhouse when • 2~5 kW (open), when the entire opening is 0.5 kW •, rolling open sh-consumption of 10 mechanical sets eggs and manure. According to statistics, fully enclosed chicken coop per chicken when the annual electricity6