113例患者注射用硫酸黏菌素应用合理性分析  

Rationality Analysis of Colistin Sulfate for Injection in 113 Patients

作　　者：刘培延 杨小红[1] 李园园[1] LIU Peiyan;YANG Xiaohong;LI Yuanyuan(Dept.of Pharmacy,Nanjing Hospital Affiliated to Nanjing Medical University/Nanjing First Hospital,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院/南京市第一医院药学部,南京210006

出　　处：《中国医院用药评价与分析》2024年第3期357-361,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：2023年度江苏省药学会-石药医院药学科研基金项目(No.SY202302)。

摘　　要：目的:探讨该院注射用硫酸黏菌素临床应用的合理性,为促进该药的临床合理应用提供参考。方法:回顾性收集2020年12月至2023年3月该院使用注射用硫酸黏菌素治疗的患者的基本信息、感染部位、病原学检查结果、用法与用量、联合用药和疗程等,参考药品说明书、指南、共识及相关文献,对注射用硫酸黏菌素临床应用的合理性进行分析。结果:共纳入113例使用注射用硫酸黏菌素的患者,其中24例患者(占21.2%)无用药指征。15例患者(占13.3%)使用负荷剂量;绝大部分患者(101例,占89.4%)静脉滴注采用了最低日剂量100万U;43例患者(占38.1%)联合雾化吸入给药,其中1例患者(0.9%)雾化吸入剂量过低。27例患者(占23.9%)使用单药治疗,4例患者(占3.5%)联合用药不符合指南或共识推荐。19例患者(占16.8%)存在疗程过短,8例患者(占7.1%)存在疗程过长。该院注射用硫酸黏菌素临床应用过程中存在用药指征把握不严、雾化吸入给药剂量过小、未联合用药及用药疗程不当等问题。结论:注射用硫酸黏菌素在该院的应用有待进一步规范,迫切需要对其药动学/药效学及临床应用等进行高质量的深入研究,以优化其用法与用量,提高用药合理性及治疗效果。OBJECTIVE:To investigate the rationality of clinical application of colistin sulfate for injection in the hospital,so as to provide reference for promoting the rational application in clinic.METHODS:General information,infection site,etiological examination results,usage and dosage,drug combination and course of treatment of patients with colistin sulfate for injection in the hospital from Dec.2020 to Mar.2023 were retrospectively collected.Rationality of clinical application of colistin sulfate for injection was analyzed by referring to drug instructions,guidelines,consensus and related literature.RESULTS:A total of 113 patients treated with colistin sulfate for injection were included,of which 24 patients(21.2%)had no indication of medication.And 15 patients(13.3%)were given a loading dose.The majority of patients(101 cases,89.4%)received the minimum intravenous daily dose of 1 million U.Totally 43 patients(38.1%)were combined with aerosol inhalation and the aerosol inhalation dose was too low in one patient(0.9%).Twenty-seven patients(23.9%)received monotherapy and 4 patients(3.5%)did not meet guidelines or consensus recommendations.The treatment course was too short in 19 patients(16.8%)and too long in 8 patients(7.1%).There were some problems in the clinical application of colistin sulfate for injection in our hospital,such as incomplete medication indication,too small dosage of aerosol inhalation,no drug combination and improper treatment course.CONCLUSIONS:The application of colistin sulfate for injection in the hospital needs to be further standardized,and in-depth research on pharmacokinetics/pharmacodynamics and clinical application is urgently needed,so as to optimize the usage and dosage of colistin sulfate for injection,and improve the application rationality and treatment outcome.

关 键 词：注射用硫酸黏菌素 耐碳青霉烯类革兰阴性菌 合理性分析 

分 类 号：R978.1[医药卫生—药品] R969.3[医药卫生—药学]