重症患者延长输注碳青霉烯类药和哌拉西林/他唑巴坦给药方案的实施效果  

Study of the Implementation of an Extended-infusion Carbapenem or Piperacillin / tazobactam Program in Critically Ill Patients

作　　者：李明艳[1] 杨志杰[1] 赖军华[2] 胡方禄[3] 

机构地区：[1]广西医科大学第四附属医院药学部,广西柳州545005 [2]广西医科大学第四附属医院ICU,广西柳州545005 [3]广西医科大学第四附属医院信息工程部,广西柳州545005

出　　处：《药物流行病学杂志》2016年第2期119-122,共4页Chinese Journal of Pharmacoepidemiology

基　　金：广西柳州市科协软科学研究项目(编号:桂科协软20140107);广西卫生和计划生育委员会自筹经费科研课题(编号:Z2015164)

摘　　要：目的:探讨延长输注碳青酶烯类抗菌药和哌拉西林/他唑巴坦在重症监护病区中推广应用的可行性。方法:对重症监护病区使用美罗培南、比阿培南和哌拉西林/他唑巴坦(PTZ)的患者应用延长输注时间的给药方案,记录新方案实施的情况。以其为观察组(EI组),传统输注法为对照组(TI组),回顾性分析两组的疗效、安全性及经济性。结果:在10个月的临床实践中,77例患者使用微泵延长抗菌药物输注时间,占总用药例数的64.2%。EI组美罗培南治疗有效率为75%,比阿培南为71.88%,均显著高于TI组(P<0.05)。两组不良反应无明显差异。三种药物EI组单位效果的成本低于TI组。结论:延长输注碳青霉烯类药及PTZ具有显著疗效及经济学优势,值得在重症患者中推广应用,但是需要医药护团队密切配合,尤其需要药师的严密监护以保证患者的用药安全有效。Objective：To study the feasibility of popularization and application of extended-infusion carhapenem or piperaeillin/tazobactam in critically ill patients in ICU. Methods： Extended-infusion dosage regimen was adopted when critically ill patients were received meropenem, biapenem or piperacillin/tazohactam. Recorded the new scheme. With extended-infusion mode as observation group （EI） and traditonal infusion as control group（TI）, the therapy effect and safety and economics were compared retrospectively between two groups. Results： In ten months＇ clincal practice, a total of 77 patients received the antibacterial agents by extended-infusions with micropump, which was 64.2% of the total drug use. The effect were significantly higher in the EI group than TI group（meropenem：75.00% , biapenem：71.88% ）, no significant difference in adverse reactions. The cost of unit effectiveness of the three drugs in EI group were lower than that of TI. Conclusion：The extended-infusion antibiotics program was superior to TI in effect and economics, which was worthy of popularization in ICU. But it needed the closed multidisciplinary collaboration , especially the pharmacists＇ rigorous moni- toring to ensure the effective and safe therapy.

关 键 词：延长输注 美罗培南 比阿培南 哌拉西林/他唑巴坦 重症患者 

分 类 号：R97[医药卫生—药品]