北京某三级医院碳青霉烯类抗菌药物使用横断面调查  

Cross-sectional survey of use of carbapenems in a tertiary hospital of Beijing

作　　者：邹琪[1] 李晓琳[1] 李娜[1] 刘聚源[1] 蔡虻[1] ZOU Qi;LI Xiao-lin;LI Na;LIU Ju-yuan;CAI Meng(Beijing Hospital National Center of Gerontology,Beijing 100730,China)

机构地区：[1]北京医院医院感染管理处国家老年医学中心,北京100730

出　　处：《中华医院感染学杂志》2020年第22期3361-3365,共5页Chinese Journal of Nosocomiology

基　　金：北京医院院级基金资助项目(bj-2018-047)。

摘　　要：目的调查北京三级医院住院患者碳青霉烯类抗菌药物使用情况。方法选择2019年11月的一个星期,对所有在北京医院住院,且在调查期间开始使用或正在使用至少一种碳青霉烯类药物(美罗培南、亚胺培南西司他丁或比阿培南)的患者进行横断面调查。结果本次调查涉及32个病房的3 492例患者,使用碳青霉烯类抗菌药物患者138例,处方数138例,占全部在院患者的3.95%。药物在移植病房使用率最高为30.00%,监护病房和呼吸内科病房次之,分别为16.67%和13.89%。药物主要用于治疗肺部感染(41.30%)、腹腔内感染(10.86)和血液肿瘤患者不明原因发热(8.70%)。所有处方中治疗用药120例(86.95%),预防用药18例(13.04%),目标治疗9例(7.50%)。病历中记录开始用药原因的处方87例,停药或回顾用药效果记录的72例,依从我国碳青霉烯类药物临床应用指南的处方105例,分别占全部处方的63.04%、52.17%和76.08%。所有处方用药途径合理,但内科病房和呼吸内科病房给药间隔合理程度较低。结论使用横断面调查方法对碳青霉烯类药物使用进行评价简便易操作,可以发现医院抗菌药物使用不合理的部门及原因,为制定院级抗菌药物管理的干预政策提供帮助。OBJECTIVE To conduct the survey for the use of carbapenems among the hospitalized patients of tertiary hospitals in Beijing. METHODS One week in November of 2019 was picked as the study period, the cross-sectional survey was conducted for the patients who were hospitalized in Beijing Hospital and started to use or were using at least one type of carbapenem(meropenem, imipenem-cilastatin or biapenem) during the survey period. RESULTS Totally 3 492 patients from 32 wards were involved in the survey, 138 patients used carbapenems with 138 prescriptions, accounting for 3.95% among the hospitalized. The utilization rate of antibiotics was the highest(30.00%) in transplantation ward, followed by care unit(16.67%) and wards of respiratory medicine department(13.89%). The drugs were mainly used for treatment of pulmonary infection(41.30%), abdominal infection(10.86%) and the hematologic tumor patients with fever of unknown origin(8.70%). Among all the prescriptions, there were 120(86.95%) cases of therapeutic medication, 18(13.04%) cases of prophylactic medication and 9(7.50%) cases of targeted medication. The reasons for treatment were recorded in 87(63.04%) antimicrobial prescriptions, and the withdrawal or review of medication effect was recorded in 72(52.17%) cases, and there were 105(76.08%) cases of prescriptions that complied to the Chinese guidelines for clinical application of carbapenems. The administration routes of all of the prescriptions were reasonable, however, the administration intervals were less reasonable in the wards of internal medicine departments and respiratory medicine departments. CONCLUSION The cross-sectional survey is a simple operation for evaluation of use of carbapenems and finds out the causes for unreasonable use of antibiotics so as to develop intervention strategies for management of antibiotics.

关 键 词：碳青霉烯类药物 横断面调查 抗菌药物管理 合理用药 

分 类 号：R969.3[医药卫生—药理学]