呼吸重症监护室患者抗菌药物利用评价  

Antimicrobial drug use evaluation of patients in respiratory intensive care unit

作　　者：朱裕林[1] 桑冉[1] 张永[1] 许健[1] 王慕华[1] 师佩兰[1] ZHU Yu-lin SANG Ran ZHANG Yong XU Jian WANG Mu-hua SHI Pei-lan(First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Chin)

机构地区：[1]蚌埠医学院第一附属医院,安徽蚌埠233004

出　　处：《泰山医学院学报》2017年第1期26-29,共4页Journal of Taishan Medical College

摘　　要：目的了解我院呼吸重症监护室(RICU)患者抗感染药物使用情况,评估抗菌药物利用的合理性。方法回顾性分析我院2013年10月—2014年9月RICU患者病历资料、实验室检查、抗菌药物应用等情况,根据《抗菌药物临床应用指导原则》,同时结合药物利用指数(DUI)对其合理性进行评价。结果细菌学送检率达90.61%,细菌培养阳性率50.00%;病原菌共检出142株,真菌65株(45.77%),革兰氏阴性菌61株(42.96%),革兰氏阳性菌13株(9.15%);单独用药32例(13.06%),联合用药213例(89.94%),联合用药方式前三位分别是β-内酰胺类及其含酶抑制剂+喹诺酮类、碳青霉烯类+喹诺酮类、碳青霉烯类+大环内酯类;使用频率前五位抗菌药物分别是左氧氟沙星、莫西沙星、美罗培南、头孢哌酮钠他唑巴坦、头孢他啶等;使用频率前十位抗菌药物DUI在0.9~1.1之间的有6种,头孢呋辛DUI最高为1.75,万古霉素DUI最低为0.48。结论 RICU患者感染较为复杂,抗菌药物的选择和联合应用基本合理,但药物剂量还需合理控制。Objective：To understand the drug use against infection in patients in our hospital RICU,and evaluate the rationality of drug use. Methods：A retrospective analysis of of RICU patients clinical data,laboratory examination and application of antimicrobial agents in our hospital from October 2013 to September 2014 was made according to the Antibacterial Drugs Principle Guidance in Clinical Application and Drug Utilization Index（DUI）to evaluate the rationality. Results：Bacte-riology inspection rate was 90. 61% ,and the positive rate of bacterial culture of 45. 31% ;pathogenic bacteria were detected in 142 strains,included 65 strains of fungi（45. 77% ）,gram negative bacilli 61 strains（42. 96% ）and gram positive bacilli 13 strains（9. 15% ）;drug therapy alone was used in 32 cases（13. 06% ）,combination was used in 213 cases（89. 94% ） The top three combination were beta lactam and enzyme inhibitor ＋ quinolones,carbapenem ＋ quinolones,carbapenem ＋macrolide and the top five frequency of use were levofloxacin,meropenem,azithromycin,imipenem and cilastatin,moxifloxacin;six were in 0. 9 - 1. 1 in the top frequency use of ten antibacterial drugs DUI,cefuroxime DUI 1. 75 was the highest and the lowest 0. 48 was vancomycin. Conclusioon：The infection is complicated in Respiratory Intensive Care Unit. The choice and usage of antimicrobial agents are basically reasonable,but the drug dosage should be controlled reasonably.

关 键 词：呼吸重症监护室 抗菌药物 药物利用评价 合理用药 

分 类 号：R978.1[医药卫生—药品]