经静脉途径使用碳青霉烯类抗菌药物的合理性  

The Rationality of Intravenous Carbapenem Antibiotics Prescription

作　　者：张金燕[1] ZHANG Jin-Yan(Department of Pharmacy,Jinan Third People's Hospital,Jinan 250000,China)

机构地区：[1]济南市第三人民医院药学部,济南250000

出　　处：《中国药物经济学》2023年第12期31-33,37,共4页China Journal of Pharmaceutical Economics

摘　　要：目的 分析经静脉途径使用碳青霉烯类抗菌药物处方的合理性,以加强抗菌药物的管理,进一步提高临床合理用药水平。方法 回顾性调查2021年度济南市第三人民医院住院部经静脉途径使用碳青霉烯类抗菌药物的出院患者有效病历458份,对其用药合理性进行点评。结果 经静脉途径使用碳青霉烯类抗菌药物排名前三的科室分别为重症监护室(32.10%)、呼吸科(24.89%)及肝胆外科(19.65%);疾病类型主要包括肺部感染(39.08%)、腹腔感染(29.69%)、重症胰腺炎(18.56%)、脓毒症(9.39%)等;本院使用最多的碳青霉烯类药物为注射用美罗培南0.5 g(38.21%)、注射用亚胺培南西司他丁钠1.0 g(26.86%)、注射用美罗培南0.25 g(20.31%);421例送检,送检率为91.92%,病原学检查结果主要为大肠埃希菌(30.40%)、肺炎克雷伯菌(24.23%)、鲍曼不动杆菌(19.71%)、铜绿假单胞菌(14.49%);458份病历中411份病历使用基本合理(89.74%),47份病历存在不同程度用药不合理(10.26%),用药不合理现象主要包括无科室相关专家会诊(44.68%)、药物选择不合理(23.40%)、用法用量不合理(19.15%)、联合用药不合理(12.77%)。结论 该院注射用碳青霉烯类抗菌药物的临床使用仍存在不合理情况,还需加强对此类药物的管理,进一步加大药学干预,提高合理用药水平。Objective To analyze the rationality of intravenous carbapenem antibiotics prescription,in order to strengthen the management of antibiotics and further improve the level of rational clinical drug use.Methods A total of 458 valid medical records of discharged patients who were treated with intravenous carbapenem antibiotics in the inpatient department of Jinan Third People's Hospital in 2021 were retrospectively investigated,and the rationality of drug use was evaluated.Results The top three departments for intravenous carbapenem use were intensive care unit(32.10%),infection and respiratory department(24.89%),and hepatobiliary and pancreatic surgery department(19.65%).The main types of diseases included pulmonary infection(39.08%),abdominal infection(29.69%),severe pancreatitis(18.56%),sepsis(9.39%),etc.Meropenem 0.5 g(38.21%),imipenem cilastatin sodium 1.0 g(26.86%)and Meropenem 0.25 g(20.31%)were more widely used than other treatment methods.A total of 421 cases were tested,with a submission rate of 91.92%.The main pathogens were Escherichia coli(30.40%),Klebsiella pneumoniae(24.23%),Acinetobacter baumannii(19.71%),and Pseudomonas aeruginosa(14.49%).Among the 458 medical records,411 medical records were basically reasonable(89.74%),and 47 medical records had different degrees of unreasonable medication(10.26%).Irrational drug use mainly included no department related expert consultation(44.68%),unreasonable drug selection(23.40%),unreasonable usage and dosage(19.15%),and unreasonable combination of drugs(12.77%).Conclusion The clinical use of carbapenems for injection in the hospital is still unreasonable,and the management of such drugs needs to be strengthened,and pharmaceutical intervention needs to be further strengthened to improve the level of rational drug use.

关 键 词：经静脉途径 碳青霉烯类抗菌药物 用药合理性 

分 类 号：R978.1[医药卫生—药品] R926[医药卫生—药学]