临床药师对碳青霉烯类药物使用管理的效果评价  

Effects of clinical pharmacists intervention on the use of carbapenems

作　　者：韩芙蓉[1] 王昕[1] 孙露[1] 顾海彤[2] 赵环宇[1] HAN Fu-rong;WANG Xin;SUN Lu;GU Hai-tong;ZHAO Huan-yua(a.Department of pharmac;b.Department of Laboratory Medicine,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,Chin)

机构地区：[1]首都医科大学附属北京同仁医院药学部,北京100730 [2]首都医科大学附属北京同仁医院检验科,北京100730

出　　处：《临床药物治疗杂志》2018年第6期47-51,共5页Clinical Medication Journal

摘　　要：目的:研究临床药师在碳青霉烯类药物使用管理中的作用,为临床合理用药提供参考。方法:回顾性分析首都医科大学附属北京同仁医院2016年8月至2018年3月临床药师干预前后急诊科出院患者碳青霉烯类药物的使用情况和细菌耐药情况。结果:碳青霉烯类药物使用率由干预前的45.1%降至干预后的13.4%(P<0.05);使用强度由干预前的31.5降至干预后的4.8(P<0.05);中位人均碳青霉烯类药物用药天数由干预前的10 d降至干预后的7d(P<0.05)。越处方权限使用的比例由干预前的26.0%降至干预后的11.4%(P<0.05),无碳青霉烯类药物使用指征的比例由干预前的52.7%降至干预后的5.7%(P<0.05)。微生物检验样本送检率由干预前的26.7%提高至干预后的88.6%(P<0.05)。干预前后鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌对亚胺培南/西司他丁耐药率的变化无统计学意义(P>0.05);干预前后铜绿假单胞菌对美罗培南耐药率变化无统计学意义(P>0.05)。结论:临床药师对碳青霉烯类药物的合理用药干预,促进了碳青霉烯类药物的临床合理用药。Objective： To study the role of clinical pharmacists in the management of clinical use of carbapenems, so as to provide references for their rational use. Methods ： The use of carbapenems and drug resistance in the Emergency Department of Beijing Tongren Hospital, Capital Medical University from August 2016 to March 2018 were retrospectively analyzed before and after intervention by clinical pharmacists. Results ： The usage rate of carbapenems decreased from 45.1 % to 13. 4%（P〈 0. 05）. The intensity of usage decreased from 31.5 to 4.8（P〈 0. 05）. The median time of carbapenem use decreased from 10 days to 7 days（P 0.05）. The percentage of exceeding authorization use decreased from 26. 0% to 11.4%（P〈 0. 05）. The percentage of non-indication use of carbapenems decreased from52. 7% to 5. 7%（P〈 0. 05）. The rate of delivering sample for microbiological examination increased from 26. 7% to 88. 6%（P〈 0. 05）. There was no statistical difference in the resistance rates of acineto bacter baumannii,pseudomonas aeruginosa,escherichia coli, Klebsiella pneumonia to imipenem/cilastatin before and after intervention（P〉0. 05）. There was no statistical difference in the resistance rate of pseudomonas aeruginosa to meropenem before and after intervention（P〉 0. 05）. Conclusion： Intervention by clinical pharmacists can promote the rational drug use of carbapenems.

关 键 词：临床药师 碳青霉烯类药物 美罗培南 亚胺培南/西司他丁 

分 类 号：R741[医药卫生—神经病学与精神病学]