肾盂肾炎患者经验用抗菌药物与药敏结果符合率  

Coincidence rates between empiric antimicrobial use and antimicrobial susceptibility testing results in patients with pyelonephritis

作　　者：张海谱[1] 梁霞[1] 贾克然[1] 赵会海[1] 史文俊[2] 王缚鲲[1] 

机构地区：[1]石家庄市白求恩国际和平医院,河北石家庄050082 [2]邯郸市解放军285医院,河北邯郸056001

出　　处：《中国感染控制杂志》2016年第1期22-25,共4页Chinese Journal of Infection Control

摘　　要：目的了解某院住院肾盂肾炎患者经验使用抗菌药物情况,为临床合理用药提供依据。方法收集2011年1月—2014年9月该院肾内科收治的620例肾盂肾炎患者资料,分析其抗菌药物应用情况,及不同种类、不同年龄患者经验用抗菌药物与细菌药敏结果符合情况。结果药敏结果报告前,620例患者应用抗菌药物625例次,其中5例患者同时应用了2种抗菌药物,共涉及8类抗菌药物15个品种,应用最多的抗菌药物依次为第三代头孢菌素、头霉素类、氟喹诺酮类。应用抗菌药物与细菌药敏结果符合率为64.32%(402例次),部分符合率为8.32%(52例次),不符合率为27.36%(171例次)。急性肾盂肾炎患者总符合率(77.61%,357例次)高于慢性肾盂肾炎(58.79%,97例次),差异具有统计学意义(P<0.05)。<50岁组、≥50岁组肾盂肾炎患者总符合率分别为68.12%(156/229)、75.25%(298/396),两组比较,差异无统计学意义(χ2=2.93,P=0.09)。结论肾盂肾炎患者经验用抗菌药物与细菌药敏结果不符合率较高,需采取措施提高经验用抗菌药物水平。Objective To understand the empiric antimicrobial use in patients with pyelonephritis in a hospital,and provide reference for clinical rational antimicrobial use.Methods Data of 620 patients with pyelonephritis admitted to the nephrology department of a hospital between January 2011 and September 2014 were collected,application of antimicrobial agents,coincidence between empiric antimicrobial use and antimicrobial susceptibility testing results in patients with different diseases and different ages were analyzed.Results Before antimicrobial susceptibility testing results were reported,620 patients use 625 times of antimicrobial agents,5 of whom used two kinds of antimicrobial agents at the same time,8 varieties in15 types of antimicrobial agents were involved,the most frequently used antimicrobial agents were third generation cephalosporins,cephamycins,and fluoroquinolones.The overall,partial,and non-coincidence rate between antimicrobial use and antimicrobial susceptibility testing results were 64.32%（n=402）,8.32%（n=52）,and27.36%（n=171）respectively.The overall coincidence rate in patients with acute pyelonephritis was higher than those with chronic pyelonephritis（77.61% [n=357]vs 58.79%[n=97],P〈0.05）.The overall coincidence rate in patients〈50 years old and≥50 years old were 68.12%（156/229）and 75.25%（298/396）respectively,there was no significant different between two groups（χ2=2.93,P=0.09）.Conclusion The non-coincidence rate between empiric antimicrobial use and antimicrobial susceptibility testing results is high,measures needs to be taken to improve the empiric antimicrobials use.

关 键 词：肾盂肾炎 抗菌药物 治疗 药敏分析 符合率 合理用药 

分 类 号：R692.7[医药卫生—泌尿科学] R969.3[医药卫生—外科学]