儿童抗菌药物个体化治疗现状的多中心调查与分析  

Multi-centre survey and analysis of individual therapy of antimicrobial agents in children

作　　者：王俊 王晓玲[2] 汪洋[1] 梅艳[1] 彭静[1] 刘茂昌 徐华[1] WANG Jun;WANG Xiaoling;WANG Yang;MEI Yan;PENG Jing;LIU Maochang;XU Hua(Dept.of Pharmacy,Wuhan Children’s Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430016,China;Dept.of Pharmacy,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院药学部,武汉430016 [2]国家儿童医学中心首都医科大学附属北京儿童医院药学部,北京100045

出　　处：《中国药房》2023年第9期1131-1136,共6页China Pharmacy

基　　金：国家呼吸系统疾病临床医学研究中心呼吸专项课题(No.HXZX-202107)。

摘　　要：目的了解抗菌药物在儿童患者个体化治疗中的开展情况。方法对全国30家儿童医院和综合医院儿科开展抗菌药物个体化治疗的情况进行问卷调查,使用Microsoft Excel 2007和SPSS 26.0软件对调查数据进行统计分析。结果本次调查共收回75份问卷,其中有效问卷53份,有效率为70.7%。调查发现,86.7%(26/30)的医院以不同形式开展了儿童抗菌药物个体化治疗。临床需求是推动多家医院开展个体化治疗的主要动力,而人员设备不足是最大障碍。开展循证药学、治疗药物监测(TDM)、模型引导的精准用药(MIPD)和抗菌药物相关基因检测的医院占比分别为70.0%、80.0%、30.0%和33.3%。各医院开展TDM的检测方式多样,涉及的儿童抗菌药物以万古霉素和伏立康唑为主。有近一半的药师对MIPD尚不甚了解。结论TDM是目前各医疗机构开展儿童抗菌药物个体化治疗的主要方式,但其监测覆盖范围及检测标准均有待提高。MIPD和抗菌药物相关的基因检测技术仍需在临床进一步推广。OBJECTIVE To investigate the development of individual therapy of antimicrobial agents in pediatric patients.METHODS A questionnaire survey was conducted to investigate the individual therapy of antimicrobial agents in 30 children’s hospitals and pediatric departments of general hospitals in China.The survey data was analyzed statistically by Microsoft Excel 2007 and SPSS 26.0 software.RESULTS In this survey,75 questionnaires were collected,and 53 of them were valid with an effective rate of 70.7%.The results showed that 86.7%(26/30)of the hospitals carried out individual therapy of antimicrobial agents in different forms.Clinical needs primarily contributed to the individual therapy in these hospitals,while the insufficient personnel and equipment were the biggest obstacles for individual therapy.The proportions of hospitals,who implemented evidencebased pharmacy,therapeutic drug monitoring(TDM),model-informed precision dosing(MIPD)and antimicrobial-related genetic tests were 70.0%,80.0%,30.0%and 33.3%,respectively.Various detection methods of TDM were carried out in various hospitals,and the antimicrobial agents which needed TDM focused on vancomycin and voriconazole.Moreover,nearly half of pharmacists did not know much about MIPD.CONCLUSIONS At present,TDM is the main way to develop individual therapy of antimicrobial agents in various hospitals,but its monitoring coverage and testing standards need to be improved.MIPD and antimicrobial-related gene tests still need to be further promoted in clinical practice.

关 键 词：抗菌药物 儿童 个体化治疗 治疗药物监测 

分 类 号：R969.3[医药卫生—药理学] R978[医药卫生—药学]