Clinical needs are guided, and antibacterial drug management and scientific decision -making under the collection must keep pace with the times.

Physician News (Rong Media Reporter Qiu Jia) The World Health Organization (WHO) issued a document. It is expected that drug -resistant bacteria infections will exceed cancer by 2050 to become the first cause of death. This is an increasingly severe challenge to the world. Promote the scientific management (AMS) project of antibacterial drugs, and calls on the world responsible to use antibacterial drugs. In order to reasonably apply antibacterial drugs, my country has also released a series of documents. Among them, in August 2012, the "Administrative Measures for the Clinical Application of Antibacterial Drugs", which is known as the "strictest restrictions in history", was officially implemented. For the first time, antibacterial drugs were divided into three levels: non -restricted use, restricted use and special use level. Since then, a series of documents such as the State Health and Health Commission have successively issued a series of documents such as the "Notice on Continuing the Management of Clinical Application of Antibacterial Drugs" to promote the hospital's better implementation of antibacterial drug grading management and achieve good results. On the other hand, in order to ensure the basic medication of the people, the country is also promoting the purchase of drugs for centralized volume. At present, the centralization of concentrated band procurement has entered a new stage of normalization and institutionalization.

Based on the special correlation between the use of antibacterial drugs and the treatment of patients and patient treatment, how to complement the management of antibacterial drugs under the centralized volume procurement policy, especially for special use of antibacterial drugs, which not only meets the needs of clinical life treatment, but also The purpose of achieving scientific management and reasonable use is not to fall into the situation of "no medicine available" and become a hot issue in the industry. To this end, the "Medical Daily" hosted a seminar on the "Antibacterial Drug Management and Scientific Decision -making" expert seminar, inviting nearly 20 authoritative experts from the nation's inspection, pharmacy, infection, breathing, etc. Discussion and experience sharing. Professor Xu Yingchun, director of the Department of Inspection of Beijing Union Hospital and director of the Department of Clinical Inspection and Diagnosis of the Beijing Union Medical College, and Professor Wang Minggui, director of the Institute of Antibiotic Research Institute of Huashan Hospital of Fudan University, served as the chairman of this seminar.

Promote the reasonable application of antibacterial drugs in the context

Become the focus of the industry

Antibacterial drug classification management is the core of antibacterial drug management. Hai Shaerjiang, an assistant researcher at the Department of Pharmacy Management and Clinical Pharmacy of Peking University School of Pharmaceuticals and Researchers at Peking University Medical Management International Research Center, introduced its team's research on the management of Chinese antibacterial drugs. Studies have found that from the "Administrative Measures for the Clinical Application of Antibacterial Drugs" in 2012 to December 2021, only 14 provinces updated over -level management directory, only 3 provinces have been updated twice, and there are two years of update in the previous two years. A certain distance. The number of medicines between the directory of different provinces is also large, and the impact of level adjustment on the level of antibacterial drugs and trends is also significant. After the level is adjusted, a significant decline will occur in dosage.

Researcher Haisharjiang introduced the 869 hospital purchasing data and drug-resistant monitoring network of 869 hospitals with continuous procurement data from 2016-2020. Promoting the advancement of collection can help optimize the catalog of antibacterial drugs, reduce costs, improve the availability of drugs, promote the production of high -quality generic drugs for domestic pharmaceutical companies, and eliminate some low -level repeated production enterprises. However, at the same time, there are also problems such as how to balance the use of bands and restrictions on the use of antibacterial drugs, and whether it will change clinical prescription behaviors and cause drug resistance. How to better design some studies, to obtain corresponding evidence to promote the reasonable application of antibacterial drugs in the context of mining, to guide clinical and decision makers to better understand the effects of the corresponding policy implementation, which is a key issue worthy of attention.

In addition to the price, we must pay more attention to quality and layered management

Since the implementation of antibacterial drugs, the prices of antibacterial drugs have been reduced, the drug can be available, and benefited more people; medical institutions at all levels have also carefully interpreted the policies, actively promoted, strictly enforced, and the reasonable implementation of antibacterial drugs was reasonable. Application plays a great role in promoting. However, previous studies have also found that after the purchase of antibacterial drugs, the intensity of antibacterial drugs is increasing, that is, the use of antibacterial drugs is increasing. Participating experts believe that although the amount of antibacterial drugs is not the only factor in bacterial resistance, the unreasonable application of unreasonable application behind the increase in use needs to be paid attention to.

On the other hand, under the procurement policy, risk control is an important measure to do a good job of reasonable medication. At present, although there is no compatible evidence to prove that some original drugs and generic drugs are not equivalent in clinical, cases that are not equivalent have also occurred. For clinicians, especially when facing critical patients who do not have time to wait, or child patients with limited medicines, the efficacy and safety of generic drugs have become the most concerned point with the original drug. As Academician Zhong Nanshan said at the first national national bacterial fungal academic conference of the Chinese Medical Association in 2021, the collection must be the first to rescue patients in crisis. It is very beneficial.

Experts said that new pathogenics are constantly emerging, drug resistance is changing, and the diseased diseases received by hospitals are also changing. The reasonable use of real anti -infective drugs requires clinical, pharmacy, microbiology, and epidemiological experts. It is necessary to consider layered management under different hospital levels, actual conditions, and clinical medication needs.

In addition, experts also reminded that Ji Cai cannot pursue prices too much, and advocating "cheap philosophy" can cause inferior products to expel good products and cause supply problems and quality problems. It is not conducive to the sustainable development of antibacterial drugs for the real quality and research and development enterprise.

On the one hand, antibacterial drug science collection and precision management of antibacterial drugs must be completed. On the other hand, the national examination should reduce the intensity of the use of antibacterial drugs and fight against bacterial resistance. How to balance the contradiction? Professor Zhang Jingyi, Director of the Department of Clinical Pharmaceuticals of the Northern Theater General Hospital, brought some experience in combining the "Consensus Expert Consensus on Performing Drug Purchase Policy Policy for Medical Institutions in Liaoning Provincial Medical Institutions".

The most important thing for the implementation of antibacterial drug collection is scientific reporting. It is necessary to adjust according to the changes in medical insurance information and hospital bacterial resistance; part. Optimize antibacterial drug directory. Principles of variety selection are comprehensive+diversified, and similar products are selected for mainstream varieties. Strictly implement the hierarchical management of antibacterial drugs, classify from safety efficacy, drug resistance and price, and effectively intercepted through informatization. Doctors cannot get rid of antibacterial drugs. Achieve all the entire process of antibacterial drugs, such as the selection of antibacterials during the siege, regulate the whole hospital through the clinical path, and engage in post -reviews to supervise during the event and move forward in advance. The clinical pharmacist played a role in accurate medication. Through MDT consultations and case discussions, inspection training, etc., the pharmacist's strengths on PK/PD provided differentiated pharmaceutical services.

Reasonable use of antibacterial drugs under the procurement of volume is system engineering, and it cannot be relying on clinical pharmacists alone. How to reduce the use of anti -infection experience and increase the target medication, and put forward requirements for clinicians' diagnosis and treatment capabilities, microbial examination rates, and inspection capacity building.

Capture: Qiu Jiajia

Edit: Qiu Jiajia

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