注射用头孢他啶阿维巴坦钠临床应用合理性分析  

Rational Analysis of Clinical Application of Ceftazidime-Avibactam Sodium for Injection

作　　者：卓佳驹 周维英 梁蓓蓓[2] 蔡芸[2] 张欢 袁梽漪[1,3] ZHUO Jiaju;ZHOU Weiying;LIANG Beibei;CAI Yun;ZHANG Huan;YUAN Zhiyi(Dept.of Pharmacology,School of Pharmacy,Chongqing Medical University,Chongqing 400016,China;Center of Medicine Clinical Research,Dept.of Pharmacy,Medical Supplies Center of Chinese PLA General Hospital,Beijing 100853,China;Chongqing Key Laboratory of Drug Metabolism Research,Chongqing 400016,China)

机构地区：[1]重庆医科大学药学院药理学系,重庆400016 [2]中国人民解放军总医院医疗保障中心药剂科药物临床研究室,北京100853 [3]重庆市药物代谢研究重点实验室,重庆400016

出　　处：《中国医院用药评价与分析》2023年第7期868-871,876,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家自然科学基金面上项目(No.82073894)。

摘　　要：目的:调查该院住院患者注射用头孢他啶阿维巴坦钠(CAZ-AVI)的应用情况,为临床合理应用CAZ-AVI提供参考。方法:搜集2020年1月至2022年2月该院使用CAZ-AVI的所有住院患者的病历资料,统计患者的人群特征、感染部位、微生物检查及药物敏感试验结果、CAZ-AVI的用法与用量、联合用药和治疗结果等相关信息,并进行分析。结果:共52例住院患者使用CAZ-AVI,其中男性患者40例,女性患者12例;年龄为23~95岁;使用CAZ-AVI前的病原学送检率为100%,检出结果主要为革兰阴性菌;43例次(占总例次数65例次的66.15%)患者按照药品说明书推荐剂量2.5 g、每8 h给药1次接受治疗;与CAZ-AVI联合应用较多的抗菌药物为替加环素、万古霉素、美罗培南和左氧氟沙星。CAZ-AVI常联合替加环素用于治疗多药耐药肺炎克雷伯菌等革兰阴性杆菌所致肺部、血流与腹腔感染,且疗效较好,不良反应较少。结论:该院CAZ-AVI的临床应用较为合理,但仍存在使用剂量不精确等问题。在临床治疗中还需严格把控适应证,密切关注疗效与不良反应,促进抗菌药物的合理应用,减少耐药。OBJECTIVE:To investigate the clinical application of ceftazidime-avibactam(CAZ-AVI)in inpatients of the hospital,so as to provide reference for rational clinical application of CAZ-AVI.METHODS:Medical records of all inpatients with CAZ-AVI in the hospital from Jan.2020 to Feb.2022 were collected,and relevant information such as population characteristics,infection site,microbial examination and drug sensitivity test results,use and dosage of CAZ-AVI,drug combination and treatment results were analyzed.RESULTS:A total of 52 inpatients were treated with CAZ-AVI,including 40 male patients and 12 female patients.The age ranged from 23 to 95 years.The pathogenic detection rate before CAZ-AVI was 100%,and the results were mainly Gram-negative bacteria.Totally 43 case-times(accounting for 66.15%of the total 65 case-times)received treatment according to the recommended dose of 2.5 g every 8 hours.The antibiotics used in combination with CAZ-AVI were tigacycline,vancomycin,meropenem and levofloxacin.CAZ-AVI mainly combined with tigecycline for the treatment of lung,blood flow and abdominal cavity infections induced by multidrug resistant Klebsiella pneumoniae and other Gram-negative bacilli,and the efficacy was significant with few adverse drug reactions.CONCLUSIONS:The clinical application of CAZ-AVI in the hospital is rational,yet there are still some problems such as inaccurate dosage.In clinical treatment,it is necessary to strictly control the indications,pay close attention to the efficacy and adverse drug reactions,promote the rational application of antibiotics,and reduce drug resistance.

关 键 词：头孢他啶阿维巴坦 合理用药 回顾性分析 

分 类 号：R978.1[医药卫生—药品]