基层医院内科住院患者大环内酯类抗生素使用情况及合理用药管理研究  

Study on the Use of Macrolide Antibiotics and Rational Drug Use Management in Inpatients of Internal Medicine in Primary Hospital

作　　者：归瑞萍 李富慧[2] GUI Ruiping;LI Fuhui(Department of Western medicine,Waizi Town Health Hospital of Xinye County,Nanyang 473555,Henan,China;Department of Neurology,Nanyang Central Hospital,Nanyang 473005,Henan,China)

机构地区：[1]河南省南阳市新野县歪子镇卫生院西医内科,河南南阳473555 [2]河南省南阳市中心医院神经内科,河南南阳473005

出　　处：《中国药物滥用防治杂志》2022年第7期876-879,共4页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:探讨基层医院内科住院患者大环内酯类抗生素使用情况及合理用药。方法:回顾性分析2019年1月—2021年1月经本院呼吸内科因呼吸系统疾病收治住院患者635例病历资料,统计呼吸系统疾病分布情况,分析大环内酯类抗生素使用情况,并计算药物利用指数(DUI)及记录院内感染及不良反应例数综合评估合理用药情况。结果:635例患者中以上呼吸道感染、社区获得性肺炎发病率居前两位,分别为38.74%、26.77%,其中儿童以上呼吸道感染多发,发病率为47.90%(205/428);成人以社区获得性肺炎多见,发病率为39.13%(81/207);2019—2020年15元环大环内酯类抗生素(阿奇霉素)使用率均位于首位,DDDs分别为4536、4903,其次为14元环大环内酯类抗生素,16元环大环内酯类抗生素居末;阿奇霉素、克拉霉素DUI>1,且应用过程中,出现6例院内感染,发生率为9.45%;8例不良反应,发生率为12.60%。结论:儿童、成年呼吸系统疾病分布存在差异,临床以14、15元环大环内酯类抗生素应用广泛,但部分药物存在药物使用不合理现象,应加强基层医院医生用药规范化管理用以提高患者用药安全性。Objective:To investigate the use and rational drug use of macrolide antibiotics in inpatients in department of internal medicine in primary hospitals.Methods:The medical records of 635 inpatients with respiratory diseases admitted to the Department of Respiratory Medicine of our hospital from January 2019 to January 2021 were retrospectively analyzed.The distribution of respiratory diseases was counted,and the use of macrolide antibiotics was analyzed.The drug utilization index(DUI)and the number of nosocomial infections and adverse reactions were recorded to comprehensively evaluate the rational drug use.Results:The incidence of upper respiratory tract infection and community-acquired pneumonia were the top two in 635 patients,which were 38.74% and 26.77%,respectively.The incidence of upper respiratory tract infection in children was 47.90%(205/428).Community-acquired pneumonia was common in adults,with the incidence of 39.13%(81/207);from 2019 to 2020,the utilization rate of 15-yuan macrolide antibiotics(azithromycin)was the highest,with DDDs of 4536 and 4903,respectively,followed by 14-yuan macrolide antibiotics,and 16-yuan macrolide antibiotics was the lowest.Azithromycin,clarithromycin DUI>1,and the application process,there were 6 cases of nosocomial infection,the incidence was 9.45%;8 cases of adverse reactions,the incidence was 12.60%.Conclusion:There are differences in the distribution of respiratory diseases between children and adults.The macrolide antibiotics with CNY 14 and CNY 15 are widely used in clinic,but some drugs are irrational in drug use.Therefore,standardized management of drug use by doctors in primary hospitals should be strengthened to improve the medication safety of patients.

关 键 词：呼吸系统 基层医院 大环内酯类抗生素 药物利用指数 

分 类 号：R969.3[医药卫生—药理学]