南部某區域醫院降低住院抗生素藥費之管理經驗

Measures to Reduce Expenditure for In-hospital Antibiotics：a Regional Hospital Policy

此研究目的是為了減少住院抗生素的藥費，自2007年10月開始實行二個策略，第一個策略是教育臨床醫師什麼情況可以不必使用抗生素及在不影響療效下如何使用較低藥價的抗生素，第二個策略是建議停用一些可被相似療效、但較低藥價取代的高藥價抗生素，包括cefmetazole、isep-amicin、flomoxef及piperacillin-tazobactam。實施14個月的結果，每個月住院抗生素平均藥費由研究前的5,895,172元（佔住院藥費的52.8%）下降到研究後的4,917,244元（佔住院藥費的48.4%）。此研究提供一種減少住院抗生素藥費的策略，是否適合各醫院採行，仍有待各醫院自行評估。

To determine measures to reduce the expenditure on antibiotics administered to hospital inpatients. Methods: In October 2007, we implemented 2 steps to reduce the expenditure on antibiotics administered during hospitalization. First, we developed a protocol to educate clinicians about the use of alternative cost-effective antibiotics with an equivalent spectrum and instructed them on the appropriate time for using such antibiotics. Subsequently, we replaced expensive antibiotics with cheaper alternatives with similar efficacy and activity. These include cefmetazole, isepamicin, flomoxef, and piperacillin-tazobactam. Results: Within 14 months of the implementation of these measures, the mean expenses incurred per month for antibiotics administered to hospital inpatients reduced from 5,895,172 NT dollars (52.8% of the expenses on drugs administered to hospital inpatients) to 4,917,244 NT dollars (48.4% of the expenses on drugs administered to hospital inpatients). Conclusion: This study highlights the effective measures that can be implemented in hospitals to reduce the expenses incurred on antibiotics administered to hospital inpatients.