我院2016年至2019年碳青霉烯类抗菌药物专档管理效果  

Effect of Special File Management of Carbapenems in Our Hospital from 2016 to 2019

作　　者：李雯[1,2] 张婷婷 肖亚雄[1] LI Wen;ZHANG Tingting;XIAO Yaxiong(The First People′s Hospital of Yibin,Yibin,Sichuan,China 644000;Sichuan Provincial Maternity and Child Health Care Hospital,Chengdu,Sichuan,China 610041)

机构地区：[1]四川省宜宾市第一人民医院,四川宜宾644000 [2]四川省妇幼保健院,四川成都610041

出　　处：《中国药业》2021年第18期25-28,共4页China Pharmaceuticals

基　　金：2018年度四川省宜宾市科技计划项目[2018SF006]。

摘　　要：目的探讨碳青霉烯类抗菌药物专档管理的效果,促进合理用药。方法收集医院2016年(专档管理前)和2017年至2019年(专档管理后)使用碳青霉烯类抗菌药物的病历2164份,采用SPSS17.0统计学软件分析微生物标本送检率、抗菌药物使用强度(AUD)、用药合理率、常见细菌耐药率。结果专档管理后,2017年至2019年使用碳青霉烯类抗菌药物前的微生物标本送检率分别为99.17%,99.38%,99.59%,均高于2016年的97.47%;药物使用不合理率分别为4.87%,2.94%,1.61%,均显著低于2016年的17.50%(P<0.01);美罗培南的AUD分别为0.31,0.28,0.22,但2016年其为临时申购品种,不参与比较;亚胺培南西司他丁的AUD分别为0.97,1.06,0.55,均显著低于2016年的1.23(P<0.05);大肠埃希菌、克雷伯菌属对碳青霉烯类抗菌药物的耐药率均低于1%,铜绿假单胞菌的耐药率波动不大,但鲍曼不动杆菌对碳青霉烯类抗菌药物的耐药率由2017年的22.80%上升至2019年的52.02%。结论该院专档管理后碳青霉烯类抗菌药物的临床使用合理率升高,但仍存在用药指征不明确、联合用药不适宜等问题,应不断持续改进。Objective To investigate the effect of special file management of carbapenems,and to promote rational drug use.Methods A total of 2164 medical records of carbapenems used in our hospital in 2016(before special file management)and from 2017 to 2019(after special file management)were collected.SPSS 17.0 statistical software was used to analyze the submission rate of microbial samples,the antibiotics use density(AUD),the rational rate of medication and the resistance rate to common bacteria.Results After the special file management,the submission rates of microbial samples for carbapenems in 2017,2018 and 2019 were 99.17%,99.38%and 99.59%,which were higher than 97.47%in 2016,and the unreasonable rates of medication in 2017,2018 and 2019 were4.87%,2.94%and 1.61%,which were significantly lower than 17.50%in 2016(P<0.01).The AUD of meropenem in 2017,2018 and 2019 were 0.31,0.28 and 0.22 respectively,but meropenem was temporarily purchased in 2016 and didn’t participate in the comparison.The AUD of imipenem cilastatin in 2017,2018 and 2019 were 0.97,1.06 and 0.55,which were significantly lower than1.23 in 2016(P<0.05).The resistance rate of Escherichia coli and Klebsiella to carbapenems was less than 1%,and the resistance rate of Pseudomonas aeruginosa fluctuated little.However,the resistant rate of Acinetobacter baumannii to carbapenem antibiotics increased from 22.80%in 2017 to 52.02%in 2019.Conclusion After the special file management in our hospital,the rationality of the clinical use of carbapenems has been significantly improved,but there are still some problems,such as unclear drug indications and inappropriate combination of drugs,which should be continuously improved.

关 键 词：碳青霉烯类 抗菌药物 耐药性 鲍曼不动杆菌 专档管理 合理用药 

分 类 号：R95[医药卫生—药学] R978.1