临床药师参与72例重症监护室感染患者药学会诊分析及典型病例  

Analysis of Pharmaceutical Consultation of 72 Patients with Infection in ICU and Introduction of Typical Cases with Clinical Pharmacist′s Participation

作　　者：韩龙 闫美兴 刘畅[1] HAN Long;YAN Meixing;LIU Chang(Women and Children′s Hospital,Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属妇女儿童医院,山东青岛266000

出　　处：《中国药学杂志》2024年第7期640-645,共6页Chinese Pharmaceutical Journal

摘　　要：目的通过分析临床药师参与重症监护室(Intensive Care Unit,ICU)感染性疾病会诊病例的特点,总结经验和效果,为促进ICU抗感染合理用药提供参考。方法收集2021年11月至2023年5月临床药师参与ICU感染会诊病例进行回顾性分析,统计归纳这些病例的基本资料、常见病原学、会诊目的、采纳率及病情转归。结果72例会诊当中,病原学检查结果为阳性的患者共60例,毒株73株,其中革兰阴性细菌35株,革兰阳性细菌28株,真菌10株,排名前三的细菌为铜绿假单胞菌(23.61%)、金黄色葡萄球菌(16.67%)、肺炎克雷伯菌(9.72%);临床会诊目的排名前三的为细菌/真菌培养阳性选定抗菌药物(47.22%)、前期方案不佳调整用药(22.22%)、特定部位感染抗菌药物的选择(12.50%);药师给出的会诊意见排名前三的为调整抗菌药物类型24例、加用抗菌药物16例、继续原有抗感染治疗方案16例;会诊意见采纳62例,未采纳10例,采纳率为86.11%,其中意见被采纳患者治疗有效率为74.19%,未被采纳患者为30.00%,意见被采纳组患者预后更好(P<0.05)。结论ICU患者因特殊性与药物选择的局限性,抗感染治疗困难,临床药师参与ICU感染患者会诊,制订药物治疗方案可以提高感染性疾病的治愈率,对促进抗菌药物的合理应用和患者预后的改善具有重要意义。OBJECTIVE To analyze the characteristics of clinical pharmacists′participation in consultation cases of infectious diseasesin the intensive care unit(ICU),summarize the experience and effect and provide reference for promoting the rational use of antiinfection drugs in ICU.METHODS A retrospective analysis was conducted on the cases of clinical pharmacists participating in ICU infection consultation from November 2021 to MAY 2023,and the basic data,common etiology,consultation purpose,adoption rate,and prognosis of these cases were statistically summarized.RESULTS Among the 72 consultations,there were 60 patients with positive etiological examination results and 73 strains of virus,including 35 strains of Gram negative bacteria,28 strains of Gram positive bacteria,and 10 strains of fungi.The top three bacteria were Pseudomonas aeruginosa(23.61%),Staphylococcus aureus(16.67%),and Klebsiella pneumoniae(9.72%).The top three clinical consultation purposes were the selection of antibacterial drugs for positive bacterial/fungal culture(47.22%),the adjustment of medication due to poor early protocol(22.22%),and the selection of antibacterial drugs for specific site infections(12.50%).The top three consultation opinions given by pharmacists were 24 cases of adjusting the type of antibacterial drugs,16 cases of adding antibacterial drugs,and 16 cases of continuing the original antiinfection treatment plan.The consultation opinions were adopted in 62 cases and not adopted in 10 cases,with an adoption rate of 86.11%.Among them,the treatment effectiveness rate of patients with accepted opinions was 74.19%,and that of patients without accepted opinions was 30.00%.The prognosis of patients with accepted opinions was better(P<0.05).CONCLUSION Due to the particularity of ICU patients and the limitation of drug selection,antiinfection treatment is difficult.Clinical pharmacists participate in consultation of ICU infected patients and formulate drug treatment plans can improve the cure rate of infectious diseases,which is of grea

关 键 词：临床药师 重症监护室 感染治疗 药学会诊 

分 类 号：R95[医药卫生—药学]