海南省人民医院注射用硫酸多黏菌素B临床应用分析  

Clinical Application of Polymyxin B Sulfate for Injection in Hainan General Hospital

作　　者：符祥俊[1] 黄莉[1] 郭丽 林良沫[1] FU Xiangjun;HUANG Li;GUO Li;LIN Liangmo(Dept.of Hematology,Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University,Hainan Haikou 570311,China)

机构地区：[1]海南省人民医院/海南医学院附属海南医院血液内科,海南海口570311

出　　处：《中国医院用药评价与分析》2021年第8期991-994,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：海南省自然科学基金面上项目(No.820MS137);海南省卫生计生行业科研项目(No.20A200071)。

摘　　要：目的:了解海南省人民医院(以下简称“我院”)注射用硫酸多黏菌素B的临床应用情况,为促进该药的合理应用提供参考。方法:以2018年1月1日至2021年3月15日于我院住院并使用注射用硫酸多黏菌素B的患者为研究对象,采用回顾性分析方法,对患者的基本信息、病原学检查结果、注射用硫酸多黏菌素B的用法与用量、联合用药、治疗结局及不良反应等进行分析。结果:共有51例患者纳入研究,其中男性患者34例(占66.67%),女性患者17例(占33.33%),平均年龄(61.31±17.98)岁;共有137份病原学阳性标本,检出革兰阴性菌115株,革兰阴性菌检出率为83.94%,其中广泛耐药及多重耐药革兰阴性菌55株(占革兰阴性菌菌株数的47.83%)。注射用硫酸多黏菌素B的用法与用量均符合药品说明书要求;平均用药疗程为(11.75±8.81)d;联合用药中,以联合碳青霉烯类抗菌药物居多。因2例患者注射用硫酸多黏菌素B使用疗程≤2 d,故对49例患者进行疗效评估,抗感染有效率为30.61%(15/49)。安全性方面,51例使用注射用硫酸多黏菌素B的患者中,22例发生急性肾损伤(占43.14%),2例发生皮肤色素沉着(占3.92%)。结论:注射用硫酸多黏菌素B的临床应用仍需严格管理,使用过程中应关注肾毒性和皮肤色素沉着等不良反应。OBJECTIVE:To investigate the clinical application of polymyxin B sulfate for injection in Hainan General Hospital(hereinafter referred to as“our hospital”),so as to provide reference for the rational use of polymyxin B sulfate for injection.METHODS:Patients admitted into our hospital from Jan.1st,2018 to Mar.15th,2021 and received polymyxin B sulfate for injection were selected as the research objectives.The basic information,results of pathogen examination,usage and dosage of polymyxtin B sulfate for injection,drug combination,treatment outcome and adverse drug reactions were analyzed retrospectively.RESULTS:A total of 51 patients were enrolled in the study,including 34 males(66.67%)and 17 females(33.33%),with an average age of(61.31±17.98)years.Totally 137 pathogenic positive specimens were detected,and 115 strains of Gram-negative bacteria were detected,the detection rate of Gram-negative bacteria was 83.94%,among which 55 strains(47.83%)of extensively drug-resistant and multi-drug resistant Gram-negative bacteria.The usage and dosage of polymyxin B sulfate for injection were in line with the requirements of the drug instructions.The average duration of medication was(11.75±8.81)d.Most of the drug combination were carbapenems.Due to the reatment course of polymycin B sulfate for injection in two patients was less than 2 d,the efficacy was evaluated in 49 patients,and the anti-infective efficiency was 30.61%(15/49).Among 51 patients with polymyxin B sulfate for injection,22 cases had acute kidney injury(43.14%),and 2 cases had skin pigmentation(3.92%).CONCLUSIONS:The clinical application of polymyxin B sulfate for injection still needs to be strictly managed,and adverse drug reactions such as nephrotoxicity and skin pigmentation should be concerned.

关 键 词：多黏菌素B 急性肾损伤 皮肤色素沉着 

分 类 号：R978.1[医药卫生—药品]