295例患者的抗菌药物不良反应分析及减少药源性损害措施的探讨  

Analysis of 295 cases of adverse reactions of antibacterial drugs and discussion of measures to reduce drug-induced damage

作　　者：刘苏利 吴寅 侯晓叶 海文利 李娜[1] 陈玉荣 LIU Suli;WU Yin;HOU Xiaoye;HAI Wenli;LI Na;CHEN Yurong(Pharmacy Department,Xi'an Gaoxin Hospital Affiliated to Northwest University,Xi'an 710075,China)

机构地区：[1]西北大学附属西安高新医院药剂科,陕西西安710075

出　　处：《临床医学研究与实践》2021年第17期20-23,27,共5页Clinical Research and Practice

摘　　要：目的总结和分析我院抗菌药物不良反应发生的规律及特点,探讨如何减少或减轻药源性损害,促进临床安全用药。方法回顾性研究医院2015—2019年上报国家药品不良反应监测系统的295例抗菌药物不良反应报告,统计、分析患者性别、年龄、抗菌药物名称及类别、给药途径、累及器官或系统、临床表现及转归等。结果295例发生抗菌药物不良反应的患者中,男患者136例(46.10%),女患者159例(53.90%);年龄分布在2 d至90岁,以>60岁和≤10岁患者居多,构成比分别为23.73%、21.36%;共涉及抗菌药物17类47个品规,发生较多的有头霉素类(72例,24.41%)、β-内酰胺类/β-内酰胺酶抑制剂(58例,19.66%)、头孢菌素类(44例,14.92%)、喹诺酮类(28例,9.49%),各类中又以头孢西丁、头孢哌酮舒巴坦、头孢呋辛、莫西沙星发生较多。药品不良反应(ADR)多出现在用药24 h内(64.41%),尤其是在用药后的30 min内(27.12%);发生ADR的给药途径主要为静脉滴注(276例,93.56%),其次为口服(19例,6.44%)。ADR可累及全身多个系统,以皮肤及其附件损害最多,共计190例次(57.23%),其次为神经系统损害(33例次,9.94%)及消化系统损害(24例次,7.23%)。结论抗菌药物不良反应会给患者带来不同程度的身体损害,临床医务人员应做到合理选药、合理用药、加强监护、及时救治,确保抗菌药物临床应用的安全性与有效性。Objective To summarize and analyze the regularity and characteristics of adverse reactions of antibacterial drugs in our hospital,and explore how to reduce or alleviate the drug-induced damage,so as to promote safe drug use in clinic.Methods A total of 295 cases of adverse reactions of antibacterial drugs reports in our hospital reported to the national adverse drug reaction monitoring system from 2015 to 2019 were retrospectively study,and gender,age,name and category of antimicrobial drugs,route of administration,involved organs or systems,clinical manifestations and outcomes of patients were counted and analyzed.Results Among 295 cases of adverse reactions of antimicrobial drugs,there were 136(46.10%)male patients and 159(53.90%)female patients;the age ranged between 2 d and 90 years old,the majority of patients were>60 years and≤10 years old,the composition ratio was 23.73%,21.36%respectively.A total of 47 products of 17 categories of antibacterial drugs were involved,with more cephamycins(72 cases,24.41%),β-lactams/β-lactamase inhibitors(58 cases,19.66%)and cephalosporins(44 cases,14.92%),quinolones(28 cases,9.49%),and cefoxitin,cefoperazone sulbactam,cefuroxime and moxifloxacin were the most common in each type.The most of adverse drug reactions(ADR)occurred within 24 h after administration(64.41%),especially within 30 min after administration(27.12%);the main administration route of ADR was intravenous drip(276 cases,93.56%),followed by oral administration(19 cases,6.44%).The ADR could affect multiple systems of the whole body,and the skin and its accessories were the most damaged,with a total of 190 cases(57.23%),followed by neurological damage(33 cases,9.94%)and digestive system damage(24 cases,7.23%).Conclusion Adverse reactions of antimicrobial drugs may cause different degrees of physical damage to patients.Clinical staff should make rational drug selection,rational drug use,strengthen monitoring and timely treatment,so as to ensure the safety and effectiveness of clinical application of antibacte

关 键 词：抗菌药物 药品不良反应 药源性损害 

分 类 号：R95[医药卫生—药学]