碳青霉烯类抗菌药物临床应用及合理性评价的断面-时点调查  

Point prevalence survey of clinical application and rationality analysis of carbapenems antibiotics

作　　者：方会慧[1] 许元宝[1] 孙旭群[1] 汪燕燕[1] FANG Hui-hui;XU Yuan-bao;SUN Xu-qun;WANG Yan-yan(Department of Pharmacy,the First Affiliated Hospital of Anhui Medical University/Third-level Laboratory of Traditional Chinese Medicine Chemistry of State Administration of Traditional Chinese Medicine,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院药剂科/国家中医药管理局中药化学三级实验室,安徽合肥230022

出　　处：《中国药物应用与监测》2022年第4期261-264,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：目的:了解我院碳青霉烯类抗菌药物的临床应用情况并进行合理性评价,为提升我院抗菌药物合理应用水平提供参考。方法:以5月16日为横断面调查时间点,统计分析2018–2021年当天所有使用碳青霉烯类药物的患者情况、碳青霉烯类抗菌药物使用情况、病原菌等,对用药合理性进行评价,并比较加强碳青霉烯类抗菌药物临床应用管理前后的变化。结果:共纳入60例患者,患者年龄1 d~87岁,主要分布在外科(28.3%)和重症监护病房(20.0%),碳青霉烯类抗菌药物多为经验性治疗,疗程以4~7 d最为多见。17例患者检出病原菌20株,主要为鲍曼不动杆菌和肺炎克雷伯菌。管理后碳青霉烯类抗菌药物处方合理率明显高于管理前(62.2%vs 35.5%,P=0.039)。不合理用药最常见的原因是无适应证和未进行会诊,管理后无适应证的病例较管理前明显减少(17.2%vs 41.9%,P=0.037),会诊改善差异无统计学意义(27.6%vs 38.7%,P=0.361)。结论:我院碳青霉烯类抗菌药物应用仍存在不合理现象,但管理措施取得了一定的成效。Objective:To explore the clinical application of carbapenems antibiotics in our hospital and evaluate its rationality,in order to provide references for improving the rational application level of antibiotics.Methods:May 16th was used as the time point of cross-sectional study.Data of patients using carbapenems on that day from 2018 to 2021 were collected and analyzed in terms of general information,application of carbapenems,pathogenic bacteria,etc for rationality evaluation.And the changes of carbapenems application before and after management were further compared.Results:A total of sixty patients aged from 1 day to 87 years old were included in this study,who were mainly distributed in the department of surgery(28.3%)and intensive care unit(20.0%).Carbapenems were mostly prescribed for empirical treatment for 4–7 d.A total of 20 strains of pathogenic bacteria were detected in 17 patients,in which the Baumannii and Klebsiella pneumoniae were the most.The rational rate of carbapenems after management was significantly higher than that before management(62.2%vs 35.5%,P=0.039).The most common reasons of irrational use of carbapenems were having no indication and no consultation.The number of cases using carbapenems without indication significantly decreased after management(17.2%vs 41.9%,P=0.037).But there was no significant difference in consultation before and after management(27.6%vs 38.7%,P=0.361).Conclusion:There were still unreasonable phenomena in the application of carbapenems,and the management measures had achieved certain results.

关 键 词：碳青霉烯类 合理性 断面-时点调查 抗菌药物管理 

分 类 号：R969.3[医药卫生—药理学] R978.11[医药卫生—药学]