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作 者:李佳[1,2] 林炽雄 范玉华[2] 何秋毅[1] 闫佳佳[1] 陈杰[1] 陈孝[1]
机构地区:[1]中山大学附属第一医院,广州510080 [2]中山大学,广州510006 [3]嘉应学院,梅州514031
出 处:《中国药事》2017年第3期328-336,共9页Chinese Pharmaceutical Affairs
摘 要:目的:评价中山大学附属第一医院非ICU住院患者使用利奈唑胺的临床合理性及其疗效和安全性,为非ICU科室的临床合理用药提供参考。方法:采用回顾性研究方法,选取我院非ICU科室2015年1月-2015年12月使用利奈唑胺注射剂或片剂的患者病例,根据药品说明书和相关指南,分析利奈唑胺的临床应用合理性,并统计有效率及不良反应发生率。结果:调查共纳入有效病例112例,其中用药合理为77例(68.75%),用药不合理35例(31.25%):用药无指征6例(5.36%),用药疗程不适宜15例(13.39%),联合用药不当11例(9.82%),8.04%的患者联用了4种以上抗菌药物。治疗结果痊愈72例,无效33例,因不良反应难以耐受停用5例,因缺药停用2例,临床治疗有效率为68.57%。用药后出现不良反应的有26例(23.21%)。结论:利奈唑胺在治疗非ICU科室患者的革兰氏阳性球菌感染时临床疗效较好,但存在不合理使用情况,使用过程中需关注其不良反应的发生。Objective: To appraise the rationality of clinical use of linezolid in non-ICU departments, as well as its efficacy and safety. Methods: A retrospective study was conducted in patients treated with LZD injection or tablets between January 2015 and December 2015 from the non-ICU departments of a tertiary hospital in Guangzhou. The rationality of linezolid, the effective rate and incidence of adverse reactions(ADR) were analyzed, referring to the drug instruction and relevant guidelines. Results: Among the 112 patients included, there were 77 cases for rational use(68.75%) and 35 cases unreasonable(31.25%); among irrational drug use, there were 6 cases having no clear indications(5.36%), 15 cases with too long or too short duration of treatment(13.39%), and 11 cases of improper combination with other antibiotics(9.82%), 8.04% of which were involved in combination with more than four kinds of antibiotics. 72 patients were cured, while 33 were invalid; 5 were discontinued due to difficulty into tolerating ADR and 2 stopped using because of deficiency of drug, resulting in an effective rate of 68.57%. ADRs were observed in 26 cases(23.21%) after medication. Conclusion: There were irrational phenomena in clinical use of Linezolid at non-ICU departments, although it showed a relatively better therapeutic effect on Gram-positive bacteria infections. ADRs should be monitored closely when using linezolid.
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