烧伤病区抗菌药物使用强度变化的回顾性分析  

Retrospective study on consumption of antibiotics in a burn unit

作　　者：于勇[1] 蒋伟[1] 朱静[1] 李少增[1] 张康[1] 翟丽惠[1] 周铮[1] 冷金昌[2] 刘小乡[3] 

机构地区：[1]解放军总医院第一附属医院检验科,北京100048 [2]解放军总医院第一附属医院信息科,北京100048 [3]解放军总医院第一附属医院统计室,北京100048

出　　处：《中华医院感染学杂志》2013年第18期4501-4502,4505,共3页Chinese Journal of Nosocomiology

基　　金：军队十二五重大科研项目(AWS11J0083)

摘　　要：目的了解烧伤病区抗菌药物使用的情况及病原菌结构与耐药水平的现状,为临床合理用药提供参考。方法计算烧伤病区2000-2011年度临床抗菌药物使用强度:DDDs/100人天,统计烧伤病区2000-2011年金黄色葡萄球菌对苯唑西林的耐药率以及鲍氏不动杆菌和铜绿假单胞菌对亚胺培南的耐药率;对抗菌药物的使用强度与3种病原菌的耐药率进行相关分析。结果 2011年三代头孢+酶抑制剂类、二代头孢、氨基糖苷类药物为使用强度最大的前3位药物,烧伤病区抗菌药物使用总强度达到52.78DDDs/100人天;3种病原菌的耐药率变化均明显升高,一、二代头孢菌素的使用强度和抗菌药物使用总强度与3种病原菌耐药率的变化密切相关。结论烧伤病区抗菌药物使用总强度和主要病原菌的耐药性均处于较高水平,降低病区抗菌药物使用的总强度,适当减少二代头孢菌素类抗菌药物的使用强度,可能会对降低病原菌耐药水平有一定的帮助。OBJECTIVE To understand the current status of antibiotic consumption and drug resistance rate of path- ogenic bacteria in a burn ward so as to guide the reasonable clinical use of antibiotics. METHODS The data of different antibiotic consumption of burn unit from 2000 to 2011 were calculated, expressed as defined daily doses （DDDs）/ 100 bed day, and the drug resistance rates of the Staphylococcus aureus to oxacillin, Pseudomonas aeruginosa to imipneme, and Acinetobacter baurnannii to imipenem in the same burn unit were counted. The correlation between the antibiotic consumption and the drug resistance rate was analyzed. RESULTS The consumptions of third generation cephalosporin plus β-lactamase inhibitor, second generation cephalosporin and aminoglycosides were increased gradually and ranked the top three among all kinds of antibiotics, with the total antibiotic consumption up to 52.78 DDDs/100 patient day;total antibiotic consumption and resistant rate of the three bacteria were also increased obviously in the same period. It was found that the consumption of first generation cephalosporin and the second generation cephalosporin was closely correlated to the drug resistance rate of the three bacteria, and the total antibiotic consumption was closely related to the change of drug resistance rate of three species of pathogens. CONCLUSION The total consumption of antibiotics and the drug resistance of the main pathogens remain at high level in the burn unit; it is suggested that to reduce the total antibiotic consumption or the consumption of second generation cephalosporin may lead to the decrease of bacterial resistance.

关 键 词：抗菌药物 烧伤患者 金黄色葡萄球菌 鲍氏不动杆菌 铜绿假单胞菌 

分 类 号：R978.1[医药卫生—药品]