202例社区获得性肺炎住院患者抗感染治疗分析  

Anti-Infective Treatment of 202 Inpatients with Community-Acquired Pneumonia

作　　者：陈敏[1] 李雷雷 CHEN Min;LI Leilei(Mianyang Central Hospital,Mianyang,Sichuan,China 621000)

机构地区：[1]四川省绵阳市中心医院

出　　处：《中国药业》2019年第14期96-96,I0002-I0005,共5页China Pharmaceuticals

摘　　要：目的为临床制订社区获得性肺炎(CAP)的治疗方案和合理用药提供参考。方法从医院信息系统(HIS)提取2016年9月至2018年3月诊断为CAP的出院患者的病历202份,按年龄和功能状态的不同分为无基础疾病青壮年组(A组,72例)和有基础疾病或老年人组(B组,130例),统计并分析两组患者的病历资料,评价抗感染治疗的合理性。结果202例患者中有190例进行了病原学检查,总送检率为94.06%;65例病原菌检出阳性,检出率为34.21%,其中细菌占35.38%,肺炎支原体占27.69%,真菌和病毒各占18.46%;B组细菌(以革兰阴性杆菌为主)和真菌的检出率高于A组,非典型病原菌和病毒的检出率低于A组;共检出混合菌感染10例(15.38%);使用例数居前3位的抗菌药物为喹诺酮类、β内酰胺类/β内酰胺酶抑制复合物、头霉素类;使用频度最高的为盐酸莫西沙星注射液,其次为哌拉西林钠他唑巴坦钠和注射用盐酸头孢替安;16例患者进行了联合抗感染治疗。结论该院CAP诊治情况基本合理,但病原菌检出率不高,部分病例未严格按抗菌药物使用指征用药等问题亟待解决。Objective To provide reference for clinical treatment and rational drug use of community-acquired pneumonia(CAP).Methods Totally 202 discharged medical records of CAP from September 2016 to March 2018 were extracted from the hospital information system(HIS)and divided into young adults without basic disease group(group A,72 cases)and basic disease or elderly group(Group B,130 cases)according to the patients'age and functional status.The data of patients in the two groups were analyzed to evaluate the rationality of anti-infective treatment.Results Among 202 patients,190 cases underwent etiological examination,t he total detection rate was 94.06%,65 cases of pathogenic bacteria were positive,the detection rate was 34.21%,of which 35.38%were bacteria,27.69%were Mycoplasma pneumoniae,18.46%were fungi and 18.46%were viruses.The detection rates of bacteria(mainly Gram-negative bacilli)and fungi in group B were higher than those in group A,while the detection rates of atypical pathogens and viruses in group B were lower than those in group A.A total of 10 cases(15.38%)of mixed bacterial infections were detected.The top 3 antibiotics used in patients were quinolones,β-lactams/β-lactamases inhibitory complexes and cephalosporins.The most frequently used drugs were Moxifloxacin Hydrochloride Injection,followed by piperacillin sodium and tazobactam sodium and Cefotiam Hydrochloride for Injection.Totally 16 patients were treated with combined anti-infective treatment.Conclusion The diagnosis and treatment of CAP in our hospital are basically reasonable,but the detection rate of pathogenic bacteria is not high.The problems such as some patients do not strictly follow the indications of antimicrobial use need to be solved urgently.

关 键 词：社区获得性肺炎 住院患者 抗感染治疗 合理用药 

分 类 号：R969.3[医药卫生—药理学] R563.1[医药卫生—药学]