8月1日起，“史上最严”的抗菌药物管理办法开始施行，各地如何落实执行是关键所在。昨天，记者从北京市卫生局获悉，结合本市临床使用抗菌药物情况，京版抗菌药目录已出炉，本市常用的125种抗菌药被分为非限制使用级、限制使用级与特殊使用级。全市二、三级医院须按照医生职称级别规范抗菌药物使用行为，严禁“越级用药”。

August 1,,"The most severe in the history of"The measures for the administration of antimicrobial agents to perform,How to implement all is the key.yesterday,Reporters from the Beijing municipal health bureau learned that,In combination with the situation of clinical use of antimicrobial agents,Beijing edition antibacterial directory already are,This city commonly used 125 kinds of antibacterial is divided into unrestricted use level/Restrict the use of level and special use level.The two/Tertiary hospital shall be in accordance with the doctor title level standard antibacterial drug use behavior,It is strictly prohibited to"Drug went".

　　

□用药 - use

　　抗生素处方权分级授予医生 Antibiotics ChuFangQuan classification awarded doctor

　　市卫生局表示，本市根据《抗菌药物临床应用管理办法》《医疗机构药事管理规定》结合卫生部《抗菌药物临床应用分级管理目录》(征求意见稿)及本市抗菌药物使用现状，经专家论证，制定了北京版抗菌药物临床应用分级管理目录。

City health bureau said,According to this city[Measures for the administration of antimicrobial drugs for clinical use][A medical institution drug management regulations]Combined with the ministry of health[The clinical application of antibacterial drugs classification management directory](draft)And this city antibacterial drug use situation,The expert argumentation,Make the Beijing edition antibacterial drug clinical application classification management directory.

　　《北京目录》共涵盖卫生部《抗菌药物临床应用分级管理目录》(征求意见稿)和本市临床常用125个抗菌药物品种(通用名)。这些药品分非限制使用级、限制使用级与特殊使用级，其中特殊使用级有27种。这些药品中不包含结核药、抗麻风病药、抗病毒药和抗寄生虫药。

[Beijing directory]Common covers the ministry of health[The clinical application of antibacterial drugs classification management directory](draft)And this city 125 clinical commonly used antimicrobial drug varieties(General name).These drugs points not restrict the use of level/Restrict the use of level and special use level,The special use level of 27.These drugs are not included in tuberculosis drug/Leprosy drug resistance/Antiviral drug and drug resistance of parasites.

　　北京严格要求医师使用不同级别抗菌药物权限，有高级专业技术职务任职资格的医师，可获特殊级处方权；有中级以上专业技术职务任职资格的医师，可获限制级抗菌药物处方权；有初级专业技术职务任职资格的医师等，可获非限制使用级抗菌药物处方权。

Beijing strict request doctors use different levels of antimicrobial agents authority,Have senior professional technical position qualifications physician,For special ChuFangQuan level;Have intermediate above professional technical position qualifications physician,For restricted ChuFangQuan antimicrobial agents;A primary professional technical position qualifications physician, etc,Can the unrestricted use level of antimicrobial agents ChuFangQuan.

　　“规范医疗机构用药行为和改善抗生素滥用现状将是本市新医改工作的重点内容之一”，昨天，北京市卫生局副局长郭晋和介绍说，市卫生局已启动抗菌药物临床应用的专项整治行动。随着抗菌药物使用办法的出台，将提速本市公立医院医药分开改革的进程，由靠“卖药”转为“卖服务”。

"Standard the medical institutions use behavior and improve the antibiotics abuse status will be the city of the new medical reform one of the important content of work",yesterday,Deputy director of the municipal bureau of health GuoJin and said,The municipal bureau of health, has been launched antibacterial drug clinical application of special improvement action.With the use of antimicrobial agents to come on stage,Will speed the city public hospital medicine separate process of reform,On the"Sell medicine"to"Sell service".

　　11家区域医疗中心获“特权” 11 regional medical center won"privilege"

　　市卫生局介绍，《目录》中标注“*”的抗菌药(主要为特殊使用级药品)，如替加环素、舒巴坦、佛罗沙星等13种药品，原则上仅限于三级医疗机构使用。

City health bureau is introduced,[directory]Label in"*"Of antibacterial(Mainly for the special use level drugs),As with ring element for/Hsu and jotham/Buddha Rosa magnitude 13 kinds of drugs,In principle is limited to level 3 medical agencies use.

　　但承担区域医疗中心任务的二级医院经本机构药事管理与药物治疗学委员会讨论通过，可以将个别注“*”的抗菌药物品种列入本机构抗菌药物供应目录。

But bear regional medical center task secondary hospital drug is approved by the mechanism of management and pharmacotherapeutics by the committee,Can individual note"*"Antibacterial drug varieties on the mechanism of antimicrobial agents supply directory.

　　据了解，目前本市10个远郊区县共设有11个区域医疗中心，承担着当地危重患者和疑难病症的救治工作，对特殊或需要会诊患者将送到城区里的三级医院。

It is understood,At present this city 10 outer suburbs area county there will be a total of 11 regional medical center,Responsible for the local critically ill patients and difficult disease treatment work,For special or need consultation patients will be sent to the city of tertiary hospital.

　　同时，特殊情况下，其它医疗机构因个案治疗需要使用此类抗菌药物的，应当由3名以上药学、临床医学等相关专业副高级职务任职资格的人员讨论后决定，做好相关记录，启动临时采购，并按规定上报卫生行政部门。

At the same time,Special circumstances,Other medical institutions for case treatment need to use this kind of antibacterial drug,Shall be by three or more pharmacy/Clinical medicine and other related professional flows position qualifications personnel after discussion decision,Completes the related records,Start temporary purchase,And according to the provisions of the administrative department of public health reports.

　

　□追问 - ask

　　医生晋升与抗菌药挂钩 The doctor promotion and antibacterial hook

　　卫生部版抗菌药管理办法明确了对医师、医院违规行为的处罚内容，但在京版办法中“未见踪影”。

The ministry of health edition antibacterial management way clear to the doctor/Hospital violations of punishment content,But in the edition way"Did not see sign".

　　市卫生局有关负责人回应称，本市采取“综合性措施”对医疗机构抗菌药物使用情况进行监管。

The municipal bureau of health officials respond to say,This city take"Comprehensive measures"Medical institutions to the use of antibacterial agents in supervision.

　　“综合性举措”中，医疗机构抗菌药物合理应用情况将与院长、科室主任综合目标考核和医生晋升挂钩，不达标的医院将被取消当年评审申报资格，医院下降一个等次。同时，医师职称晋升、绩效收入等也将视抗生素使用情况而定。按照此前规定，对存在不合理用药问题的医师，将视情形予以警告、限期整改，甚至可吊销执业证书等处理。

"Comprehensive measures"in,A medical institution antibacterial drug reasonable application will and dean/Department director comprehensive target evaluation and the doctor promotion hook,Substandard hospital will be cancel the qualification of the declaration,Drop a hospital after the order of melchizedek.At the same time,Physician title promotion/Performance income and will also apparent antibiotic usage situation and decide.In accordance with the provisions after,The existing problems of the doctors not rational drug use,Depending on the situation will be warned/Deadline rectification,Even revoke a practice certificate and so on.

　　该负责人表示，在此次药品目录发布后，相关的监管举措也将一一亮相。

This person in charge said,In the catalog of medicines and after release,Relevant regulatory measures will also appear one by one.

　

　125种药够用并可调整 125 kind of medicine enough and can be adjusted

　　125种抗生素是否够用？中日友好医院创伤骨科主任林朋表示，三级医院常用的抗生素约四五十种，较为固定，总数125种的药品目录应该够各级各类医院使用。

125 kinds of antibiotics is enough?The sino-japanese friendship hospital director of orthopaedic trauma dauri said,Tertiary hospital commonly used antibiotics of about forty or fifty,Relatively fixed,A total of 125 kinds of drug catalogue of all types and at all levels should be enough to use hospital.

　　市卫生局表示，对于确需使用《目录》外的抗菌药物品种的情况，医疗机构应在使用前报市卫生局备案。市卫生局将定期组织专家，对备案情况进行论证，并将根据实际情况适时调整该目录品种，但未经备案的禁止采购。

City health bureau said,For if it is really necessary to use[directory]The antibacterial drug kinds of situation,A medical institution shall before use the municipal health bureau for the record.The municipal bureau of health, will organize experts,The record of the argument to situation,According to the actual situation and timely adjust the directory varieties,But the record's ban without purchasing.

　

　药品分级 Drug classification

　　>>非限制级

>>Non r-rated

　　种类：包括四环素、阿莫西林、头孢拉定、阿莫西林等。开方人：具有初级专业技术职务任职资格的医师，在乡、民族乡、镇、村的医疗机构独立从事一般执业活动的执业助理医师以及乡村医生。

kinds:Including tetracycline/amoxicillin/cefradine/Amoxicillin, etc.Radication people:Has the primary professional technical position qualifications physician,In the country/Nationality townships/town/Village medical institutions engaged in general practice activities independently assistant practicing doctors and rural doctors.

　　>>限制级

>>r-rated

　　种类：米诺环素、氯霉素、莫西沙星等。开方人：具有中级以上专业技术职务任职资格的医师。

kinds:Camino ring element/chloramphenicol/Mo xisha magnitude.Radication people:With intermediate, the above professional technical position qualifications physician.

　　>>特殊级

>>Special level

　　种类：万古霉素、替加环素等27种。开方人：具有高级专业技术职务任职资格的医师。

kinds:vancomycin/Add ring for meat, and other 27 kinds of.Radication people:With senior professional technical position qualifications physician.

　　本报制图何将

What will our drawing

　　本版采写本报记者李秋萌

This LiQiuMeng concludes our reporter