目的 對西安市第一醫(yī)院β-內(nèi)酰胺類抗生素/β-內(nèi)酰胺酶抑制劑復方制劑（簡稱β-內(nèi)酰胺酶抑制劑復方制劑）的臨床應用情況、用藥趨勢及合理性進行分析，為其規(guī)范化管理和臨床合理用藥提供參考。方法 對2015—2019年西安市第一醫(yī)院β-內(nèi)酰胺酶抑制劑復方制劑的銷售金額、用藥頻度（DDDs）、日均費用（DDC）、藥品排序比（B/A）和科室分布等進行統(tǒng)計和分析，并抽取β-內(nèi)酰胺酶抑制劑復方制劑住院病例500份，對其合理性進行評價。結(jié)果 β-內(nèi)酰胺酶抑制劑復方制劑銷售金額和DDDs總體呈增長趨勢，其中注射用美洛西林鈉舒巴坦鈉和注射用頭孢哌酮鈉舒巴坦鈉位居前2位。DDC從2017年起有不同程度的下降，各品種間DDC差異較大。注射用美洛西林鈉舒巴坦鈉和注射用頭孢哌酮鈉舒巴坦鈉B/A為1.00，同步性較好；注射用哌拉西林鈉舒巴坦鈉和注射用哌拉西林鈉他唑巴坦鈉B/A小于1.00，使用成本較高；注射用阿莫西林鈉克拉維酸鉀和阿莫西林克拉維酸鉀分散片B/A大于1.00，使用成本較低。β-內(nèi)酰胺酶抑制劑復方制劑科室分布于呼吸內(nèi)科、泌尿外科、腎臟內(nèi)分泌科、神經(jīng)內(nèi)科、神經(jīng)外科、重癥醫(yī)學科、心血管內(nèi)科、干部病房、康復醫(yī)學科、兒科等，臨床應用較廣泛。抽取的500份應用β-內(nèi)酰胺酶抑制劑復合制劑住院病例，有53例存在用藥不合理的情況，其中適應癥不適宜45例（9%），用藥療程不適宜4例（0.8%），用法用量不適宜3例（0.6%），聯(lián)合用藥不適宜1例（0.2%）。結(jié)論 西安市第一醫(yī)院β-內(nèi)酰胺酶抑制劑復方制劑臨床應用基本合理，但仍存在選擇抗菌藥物價格高和起點高的問題，今后應進一步加強對β-內(nèi)酰胺酶抑制劑復方制劑的管理。

Objective To analyze the clinical application and trend of β-lactamase inhibitors compound in the hospital, and to provide reference for standardized management and rational clinical use of drug. Methods The data of utilization of β-lactamase inhibitors compound in the First Hospital of Xi’an from 2015 to 2019 were collected and analyzed statistically, and consumption sums, frequency of drug use (DDDs), defined daily cost (DDC), drug sequence ratio (B/A) and department distribution were calculated and analyzed. A retrospective analysis was made of 500 medical records of the patients using β-lactamase inhibitors compound, and the medication rationality of β-lactamase inhibitors compound was evaluated. Results The consumption sums and DDDs of β-lactamase inhibitor compound showed an overall growth trend, among which meloxicillin sodium sulbactam sodium for injection and cefoperazone sodium sulbactam sodium for injection were the top two. Since 2017, DDC has decreased to different degrees, and there was a big difference in DDC among varieties. B/A values of meroxicillin sodium sulbactam sodium for injection and cefoperazone sodium sulbactam sodium for injection were 1, indicating good synchronization. B/A values of piperacillin sodium sulbactam sodium for injection and piperacillin sodium tazobactam sodium for injection were less than 1, the use cost was higher; B/A values of amoxicillin sodium potassium clavulanate for injection and amoxicillin potassium clavulanate dispersible tablets were more than 1. The β-lactamase inhibitor compound was widely used in respiratory medicine, urology, kidney endocrinology, neurology, neurosurgery, intensive medicine, cardiovascular medicine, cadre ward, rehabilitation medicine, pediatrics, etc. There were 53 cases of irrational use records, in which, improper indications (9%), appropriate course of treatmen (0.8%), irrational dosage (0.6%) and improper drugCombination (0.2%) were the major problems. Conclusion The clinical application of β-lactamase inhibitor compounds is basically reasonable in the hospital, but there are still problems of high price and high starting point for the selection of antibiotics, so the management of β-lactamase inhibitor compounds should be further strengthened in the future.

R978.1