限药令实施近半月，能管住过度用药吗？记者调查 Limited to implement nearly half a medicine，Take excessive medication？A survey

　　

药店买眼膏，也要凭处方 Drug store to buy them，And by prescription

　　

医生开大方，电脑会报警 The doctor prescribed generous，Computer will alarm

　　去药店，即使是买一支金霉素眼膏也需要出示处方；医院里那些“小年青”医生是不能开高级抗菌药的；医院的电脑系统，已自动设定了“警戒线”，无故开出二三种抗菌药的处方单，马上提示报警，成为废纸一张。

Went to a chemist's shop，Even buy a aureomycin also need to present them prescription；Hospital those“Small young”A doctor cannot open the senior antibiotic；The hospital's computer system，Already automatically set“cordon”，On 23 kinds of antibiotic without the tear，Immediately tip alarm，Become waste paper a。

　　8月1日，卫生部出台被称为“史上最严限药令”的《抗菌药物临床应用管理办法》正式实施。办法规定，建立起抗菌药物临床应用分级管理制度，将抗菌药物分为非限制使用、限制使用和特殊使用三级管理，医生未按规定开具抗菌药物处方的将被取消处方权。

August 1,，The health ministry issued is called“History's most severe limit to medicine”of《Measures for the administration of antimicrobial drugs for clinical use》Formally implementing。measures，Establish antibacterial drugs for clinical use grading management system，Will be divided into the limiting the use of antibacterial drugs、Limiting the use of and special use level 3 management，The doctor did not press formulary issue of antimicrobial prescription will be cancelled ChuFangQuan。

　　为何要对抗菌物采取“限药令”？目前杭州的医院和药店实施情况如何？医生与患者是否都能接受？本报记者对此进行了深入的调查。

Why take this fight“Limit medicine to”？At present, hangzhou and implementation of the hospital pharmacy？Doctors and patients are acceptable？Our reporter this deeply investigation。

　　

调查一 A survey

　　

自费病人买“头孢”药店执行较松 Patients at one's own expenses buy“cephalosporins”Enterprise executive is loose

　　记者昨日在中河高架下的一家药店门口，偶遇38岁的朱先生，他是为自己年过六旬的父亲来买药的：“他是老慢支，五六年了，每年秋天开始就不对劲儿，咳嗽、痰多，吃点抗菌药阿莫西林就好了。已经立秋了，虽然天气还挺热，但我总觉得家里要备点药，要不，老往医院跑也麻烦。”

Reporters yesterday in under the elevated in the river at the door a pharmacy，Encounter at the age of 38 Mr. Zhu，He is for his years of a father to buy drugs：“He is old bronchitis，Five or six years，Each fall to the wrong is，cough、Much sputum，Eat some antibiotic amoxicillin。Has been the beginning of autumn，Though the weather was hot，But I always feel like home to prepare some medicine，or，Old to hospital run also trouble。”

　　但是，他跑了3家药店，没有一家肯卖给他。

but，He ran three drugstore，No one will sell it to him。

　　记者之后又踏进庆春路上一家海王星辰健康药房，记者问：“有头孢吗？”(一种常用抗菌药)

Reporters and step into qingchun road after a sea stars health pharmacy，The reporter asked：“Cephalosporins have?？”(A common antibiotic)

　　服务员回答得直截了当：“买这个药是要处方的。”

The waiter replied to straightforward：“This medicine is to buy prescription。”

　　记者又表示想买一支金霉素眼膏，涂眼睛消炎。对方紧接着说，这个现在按规定也是要处方的，但因为有驻店医生，可以检查一下然后再开。

The reporter also said that want to buy a aureomycin them，Eyes diminish inflammation with。Each other and then said，This now is the prescription according to regulations，But because there are resident doctor，Check and then open again。

　　记者随后又探访了位于秋涛路上的老百姓大药房。这家药店规模比较大，配备十几位导购员。

Reporter then visited the autumn of common people out in the way large pharmacy。The enterprise scale is larger，Equipped with more than ten 导购员。

　　记者想买“头孢”。其中一位说：“如果用医保，那么只能带处方来，如果是自费的，就可以直接买。”当被问及有没有数量限制时，她说：“这种药现在在其他地方也很难买的，吃多了有坏处。”

The reporter wants to buy“cephalosporins”。One of them said：“If use medical insurance，So can only take prescription，If is the at one's own expenses，Can buy direct。”When asked about any quantity limit，She said：“This medicine is now in other places and it is hard to buy，Eat more have its downside。”

　　再问处方药柜台的导购员，买头孢的要求一开始被拒绝，但是再要求了一次之后，柜台服务员默许，记者顺利买到了药。如此看来，这家大药店对“限药令”的执行还有欠缺。

Ask the 导购员 prescription counter，Buy the requirements of cefazolin a beginning to be rejected，But ask for a later，Desk clerk tacit approval，Reporter smooth bought medicine。So it seems，The big pharmacy to“Limit medicine to”Executive and deficient。

　　原来，记者了解到，医保部门目前对抗菌药也有严格的使用规定。在药店里配抗菌药，必须留下处方记录，如果没有，可能面临医保部门的处罚。而对自费患者来说，则不受这一限制，就宽松多了。(记者 王蕊 林丹 通讯员 牟优优 王程灵)

The original，The reporter understands，Health care providers at present also had strict antibiotic use policy。In pharmacies with antibiotic，Must leave prescription records，If no，May face health care providers of punishment。And for people at one's own expenses，Is not affected by this restriction，Is much more relaxed。(Reporter WangRui Lin Dan correspondent seeks optimal optimal WangCheng spirit)

　　

调查二 The survey

　　

去医院做小手术基本不用抗菌药 Go to a hospital making small operation basic need not antibiotic

　　傅先生因甲状腺多发性结节做了手术，昨天出院。

Mr. Fu for thyroid multiple nodules to do the surgery，Hospital yesterday。

　　他告诉记者：手术前医生没有给他输液过，手术后也没看见收费单里有抗菌药，甚至出院了，医生也没开任何抗菌药让他带回家。

He told reporters：The doctor didn't give him before the operation infusion，Surgery also didn't see bill has antibiotic，Even was released from the hospital，The doctor didn't also open to any antibiotic brought him home。

　　“十几年前，我有个朋友因为同样的毛病住院，我看他用了好几种抗菌药。”

“Ten years ago，I have a friend in hospital for the same problem，I see he spent several kind of antibiotic。”

　　原来从今年开始，在浙医二院，大部分的甲状腺手术病人，都不用抗菌药。

Originally from the beginning of this year，In ZheYi. 2 hospital，Most of the thyroid surgery patients，All need not antibiotic。

　　浙医二院感染管理科主任王选锭解释说，甲状腺、乳腺等手术，只在体表做一个切口，不会影响到身体其他地方，所以，局部使用抗炎药就可以，不需要输液或者口服抗菌药，即使有少数细菌入侵，我们身体自己的免疫细胞也可以将它杀灭。

ZheYi. 2 hospital infection management division director ingot queen explained，thyroid、Breast surgery such as，Just do a cut in the body，Won't affect other parts of the body，so，Local use anti-inflammatory drug，Don't need transfusion or oral antibiotic，Even with a few the bacteria，We the body's own immune cells can also will kill it。

　　目前，该院对甲状腺、乳腺、疝修补等小手术病人，95%不用抗菌药；冠脉造影及射频等介入治疗，全部不用抗菌药……

At present，Of the thyroid、breast、Hernia repair, and other small surgery patients，95% don't antibiotic；Coronary angiography and rf intervention, etc，All need not antibiotic...

　　王选锭说，他刚刚参与修订了围手术期抗菌药物预防使用原则，这是2004年以后的第一次大修订，类似手术不用抗菌药，今后所有医院都要达标。(记者 林丹 通讯员 方序)

Ingot said queen，He just participate in revised perioperative use antimicrobial drug prevention principle，This is 2004 years after the first major revision，Without antibiotic such an operation，All future hospital to the standards。(Reporter Lin Dan correspondent party sequence)