Article(id=1292135493458743469, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292135444850955150, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2026.09.018, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1768147200000, receivedDateStr=2026-01-12, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785998708357, onlineDateStr=2026-08-06, pubDate=1778947200000, pubDateStr=2026-05-17, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785998708357, onlineIssueDateStr=2026-08-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785998708357, creator=13701087609, updateTime=1785998708357, updator=13701087609, issue=Issue{id=1292135444850955150, tenantId=1146029695717560320, journalId=1246415772164075586, year='2026', volume='42', issue='9', pageStart='1201', pageEnd='1350', issueExtLink='null', onlineDate='null', pubDate='1778947200000', pubDateStr='2026-05-17', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785998696767, creator='13701087609', updateTime=1786014392260, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1292201276780081469, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292135444850955150, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1292201276784275774, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292135444850955150, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1316, endPage=1322, ext={EN=ArticleExt(id=1292135493844619438, articleId=1292135493458743469, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Analysis of the rationality of nebulized drug prescriptions in pediatric outpatient and emergency departments based on the rational medication use system, columnId=1291704944038536012, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Rational Use of Drugs, runingTitle=null, highlight=null, articleAbstract=
Objective To analyze the rationality of outpatient and emergency nebulization medication prescriptions in a tertiary pediatric specialty hospital based on the hospital’s rational drug use system, identify the main types, distribution characteristics, influencing factors of irrational prescriptions, and provide evidence for standardizing clinical medication use.
Methods All outpatient and emergency prescriptions containing nebulized drugs from January to December 2024 were collected. Prescriptions were initially screened using the Puhua Hecheng rational drug use system, followed by manual review by pharmacists according to standards such as the "clinical practice guidelines for nebulized inhalation therapy in pediatric respiratory diseases (2024 edition)". A retrospective analysis was conducted on irrational prescriptions.
Results A total of 233 736 prescriptions were included. Initial screening identified 8 569 positive irrational prescriptions, and after review, 3 681 were confirmed as true positive irrational prescriptions, resulting in an overall irrationality rate of 1.57% (3 681 prescriptions/233 736 prescriptions). Irrational prescriptions were mainly from outpatient departments 70.33% (2 589 prescriptions/3 681 prescriptions), with emergency departments accounting for 29.67% (1 092 prescriptions/3 681 prescriptions). School-age children (36.00%, 1 325 prescriptions/3 681 prescriptions) and preschool children (35.51%, 1 307 prescriptions/3 681 prescriptions) were the high-risk groups. The departmental distribution showed a "long-tail distribution," with the top 10 departments accounting for 60.69% (2 234 prescriptions/3 681 prescriptions), primarily the respiratory center, gastroenterology department, and internal medicine teaching and research department. Among irrational prescription types, inappropriate indication was the most common (86.80%, 3 853 cases/4 439 cases), followed by inappropriate usage and dosage (9.89%,439 cases/4 439 cases), duplicate medication (1.85%, 82 cases/4 439 cases) and inappropriate route of administration (1.46%, 65 cases/4 439 cases). Among medication categories, inhaled corticosteroids (71.13%, 3 065 cases/4 309 cases) had the highest incidence of issues, with budesonide suspension for inhalation accounting for 60.43% (2 604 cases/4 309 cases), followed by bronchodilators, with ipratropium bromide solution for inhalation accounting for 23.25% (1 002 cases/4 309 cases).
Conclusion The overall rationality of nebulized drug prescriptions in the outpatient and emergency departments of the hospital is favorable. Irrational medication issues are dominated by inappropriate indications, mainly concentrated in young children and departments with high-frequency use of nebulized drugs. To improve the rationality of clinical medication, a full-process management system of "prevention-control-optimization" should be established by strengthening guideline training, optimizing audit rules of the rational drug use system, and enhancing targeted management in key departments.
, authors=Zhao-yang DU, Qiang SHI, Jin-jing MA, Xin LIU, Lei ZHANG, Zi-yang SONG, Xin-wei CHEN, Jing-hai WEI, Peng GUO, authorsList=Zhao-yang DU, Qiang SHI, Jin-jing MA, Xin LIU, Lei ZHANG, Zi-yang SONG, Xin-wei CHEN, Jing-hai WEI, Peng GUO, authorCompany=null, correspAuthors=Peng GUO, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1292135494134026415, articleId=1292135493458743469, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=基于合理用药系统的儿童专科医院门急诊雾化药物处方合理性分析, columnId=1291704944210502478, journalTitle=中国临床药理学杂志, columnName=合理用药, runingTitle=null, highlight=null, articleAbstract=
目的 依托医院合理用药系统，分析某三级儿童专科医院门急诊雾化药物处方的合理性情况，明确不合理处方的主要类型、分布特征及影响因素，为临床用药规范提供依据。
方法 收集2024年1月至12月本院门急诊所有含雾化药物的处方，依托普华和诚合理用药系统进行机筛，并由药师依据《儿童呼吸系统疾病雾化吸入治疗临床实践指南（2024年版）》等标准进行人工复审，对不合理处方进行回顾性分析。
结果 共纳入233 736张处方，机筛阳性不合理处方8 569张，经复审确认为真阳性不合理处方3 681张，整体不合理率为1.57%（3 681张/233 736张）。不合理处方以门诊为主70.33%（2 589张/3 681张），急诊占比29.67%（1 092张/3 681张），学龄儿童36.00%（1 325张/3 681张）与学龄前儿童35.51%（1 307张/3 681张）为高发人群，科室分布呈“长尾分布”，前10位科室累计占比60.69%（2 234张/3 681张），以呼吸中心、消化科、内科教研室为主要高发科室。不合理类型中，适应症不适宜占比最高为86.80%（3 853项/4 439项），其次为用法用量不适宜9.89%（439项/4 439项）、重复用药1.85%（82项/4 439项）和给药途径不适宜1.46%（65项/4 439项）。药品类别中以吸入性糖皮质激素问题最多，占比71.13%（3 065条/4 309条），其中布地奈德混悬液占60.43%（2 604条/4 309条），其次为支气管舒张剂，其中吸入用异丙托溴铵溶液占23.25%（1 002条/4 309条）。
结论 本院门急诊雾化药物处方整体合理性较好，不合理问题以适应症不适宜为核心，聚焦于低龄儿童、高频使用雾化药物的科室，需通过强化指南培训、优化合理用药系统审核规则、加强重点科室专项管理等措施构建“预防-管控-优化”全流程管理体系，提升临床用药合理性。
, authors=杜朝阳, 史强, 马津京, 刘新, 张雷, 宋子扬, 陈鑫伟, 魏京海, 郭鹏, authorsList=杜朝阳, 史强, 马津京, 刘新, 张雷, 宋子扬, 陈鑫伟, 魏京海, 郭鹏, authorCompany=null, correspAuthors=郭鹏, authorNote=
杜朝阳（1991-），女，主管药师，主要从事儿科临床药学研究和工作
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