临床药师参与特殊使用抗菌药物会诊对细菌耐药变迁的影响  

Impact of clinical pharmacists′involvement in special use of antibiotics on change of bacterial resistance

作　　者：赵振寰[1] 荆伟丽[1] 孟德宝[1] 纪俐娜[1] 隋忠国[1] 

机构地区：[1]青岛大学医学院附属医院药学部,山东青岛266003

出　　处：《中华医院感染学杂志》2013年第18期4516-4518,共3页Chinese Journal of Nosocomiology

基　　金：青岛市科技发展计划项目(13-1-3-32-nsh)

摘　　要：目的探讨临床药师参与特殊使用抗菌药物会诊对抗菌药物用量和细菌耐药变迁的影响,促进抗菌药物合理使用。方法回顾分析临床药师参与特殊使用抗菌药物会诊前后特殊使用抗菌药物DDDs值变化,统计分析其中主要病原菌对特殊使用抗菌药物的耐药趋势。结果临床药师参与特殊使用抗菌药物会诊后,特殊使用抗菌药物DDDs值有了明显的下降,头孢吡肟DDDs值由8472降至478,帕尼培南DDDs由838降至264,亚胺培南DDDs值由753降至374,替考拉宁DDDs值593降至303;大肠埃希菌对头孢吡肟的耐药率由69.0%降为58.3%、阴沟肠杆菌对头孢吡肟的耐药率由29.5%降为10.5%、铜绿假单胞菌对头孢吡肟的耐药率由17.5%降为10.5%;MRSA检出率由70.3%降为60.5%,大肠埃希菌ESBLs检出率由69.0%降为59.2%。结论临床药师参与特殊使用抗菌药物会诊能促进抗菌药物的合理使用,并在一定程度上延缓细菌耐药率的增长。OBJECTIVE To investigate the impact of clinical pharmacists＇ consultation on clinical application of antibacterials on the DDDs and the bacterial resistance so as to guide the reasonable use of antibiotics. METHODS The DDDs of antibacterials in special need was retrospectively analyzed before and after the clinical pharmacists＇ consultation on the special use of antibiotics, then the drug resistance of the main species of pathogens to the antibiotics in special need were statistically analyzed. RESULTS After the clinical pharmacists＇ participating in the consultation of special use of antimicrobial drugs, the DDDs value of the special use of antimicrobials was significantly decreased, with the DDDs value of cefepime deceasing from 8472 to 478, panipenem from 838 to 264, imipenem from 753 to 374, and teicoplanin from 593 to 303. The drug resistance rate of Escherichia coli to cefepime decreased from 69.0 % to 58.3 %, the drug resistance rate of Enterobacter cloacae to cefepime dropped from 29.5 % to 10.5 %, and the drug resistance rate of Pseudomonas aeruginosa to cefepime decreased from 17.5 % to 10.5 %. The positive rate of MRSA dropped from 70.3 % to 60.5 %, and the positive rate of ESBL-producing E. coli decreased from 69.0 % to 59.2 %. CONCLUSION The clinical pharmacists＇ participation in consultation on clinical application of antibacterials in special need can promote the rational use of antibiotics, and to some extent may retard the growth of drug resistance.

关 键 词：细菌耐药 特殊使用抗菌药物 临床药师 

分 类 号：R978.1[医药卫生—药品]