台灣上呼吸道感染抗生素使用之調查分析

Antibiotic Usage in Upper Respiratory Tract Infection in Taiwan

10.6526/ICJ.200406_14(3).0001

張上淳(Shan-Chwen Chang)；陳淑姬(Shu-Chi Chen)；龐一鳴(I-Ming Parng)；賴美淑(Mai-Shu Lai)

上呼吸道感染 ； 抗生素 ； 抗藥性 ； upper respiratory tract infection ； antibiotic ； antibiotic resistance

感染控制雜誌

14卷3期（2004 / 06 / 01）

133 - 139

繁體中文

為瞭解台灣基層醫療院所之醫師對於上呼吸道感染病人之抗生素使用情形，乃利用健保局之資料庫，針對北區分局所屬基層西醫診所及地區醫院醫師於民國88年12月至89年2月間所有申報之上呼吸道感染個案的抗生素使用情形，進行統計分析。在此三個月期間合計有1,901位醫師有申報上呼吸道感染個案，扣除平均每月診療上呼吸道感染個案少於60例者，計有1,151位醫師為統計分析之對象。這些醫師個人在三個月期間診療之上呼吸道感染個案數由180人次至15,238人次，而他們所診療之上呼吸道感染個案的抗生素使用比例平均分佈於0%至100%之間，其中合計有76.7%的醫師，抗生素使用率超過20%，而抗生素使用率高於50%的醫師有46.1%，甚至有30位醫師（佔2.6%）100%的病人均使用抗生素。此結果顯示台灣很多基層醫師確實對於上呼吸道感染病人有嚴重的抗生素過度使用之情形。

We studied the antibiotic usage for patients with upper respiratory tract infections (URI) by the physicians in the clinics and the out patient department of primary care local hospitals in Northern Taiwan. The data were collected from the National Health Insurance Bureau and analyzed. The study period began from December 1(superscript st), 1999 and ended on February 28(superscript th), 2000. During this 3-month period, there were 1,901 physicians who reported management of patients with URI. Excluding those who treated less than 60 cases per month, the number of URI patients and the number of patients treated with antibiotics in each individual physician among 1,151 physicians were analyzed. They treated 180 to 15,238 URI patients individually during the three-month study period. The rates of antibiotic usage among these physicians were evenly distributed between 0 to 100%. Seventy-six percent of them used antibiotics in more than 20% of URI patients. Forty-six percent of the physicians used antibiotics in more than 50% of URI patients. Thirty physicians (2.6%) used the antibiotics in 100% of URI patients! These data reveals that overuse of antibiotics for the URI patients in Taiwan is serious. This is probably one of the important factors contributing to the high rate of antibiotic-resistance in many pathogenic bacteria in Taiwan.