360例住院患者氨基糖苷类抗感染药物使用情况分析  

Application of Aminoglycoside Anti-Infective Drugs in 360 Inpatients

作　　者：付观双 周维英 蔡芸[2] 梁蓓蓓[2] 沈正泽[1,4] FU Guanshuang;ZHOU Weiying;CAI Yun;LIANG Beibei;SHEN Zhengze(School of Pharmacy,Chongqing Medical University,Chongqing 400016,China;Pharmacy Clinical Laboratory,Medical Support Center,Chinese People’s Liberation Army General Hospital,Beijing 100853,China;Chongqing Key Laboratory of Drug Metabolism research,Chongqing 400016,China;Dept.of Pharmacy,Yongchuan Hospital,Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学药学院,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 [4]重庆医科大学附属永川医院药学部,重庆400016

出　　处：《中国医院用药评价与分析》2024年第6期743-747,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：重庆市临床药学重点专科建设项目(No.渝卫办[2023]69号);重庆医科大学未来医学青年创新团队支持项目(No.W0067)。

摘　　要：目的:了解氨基糖苷类抗感染药物在住院患者中的使用情况,促进临床合理用药。方法:回顾性分析2023年1月1日至6月1日某院全身性使用氨基糖苷类抗感染药物的住院患者的人口学资料、用药情况、病原学检查、联合用药情况、用药不良反应等,并进行统计分析。结果:共360例住院患者在此期间全身性使用氨基糖苷类抗感染药物,包括阿米卡星、依替米星和庆大霉素;其中男性患者251例,女性患者109例,平均年龄为(60.39±18.11)岁;患者使用氨基糖苷类抗感染药物主要用于治疗革兰阴性菌感染,且多与β-内酰胺类药物联合应用;202例为治疗用药,治疗有效率为91.09%(184/202);共有25例患者(占6.94%)用药后血肌酐水平较前明显升高;133例患者存在不合理用药,包括给药剂量不合理24例(占18.05%)、联合用药不合理39例(占29.32%)、预防用药疗程不合理52例(占39.10%)、围手术期给药时间不合理25例(占18.80%)以及预防用药选择不合理12例(占9.02%)。结论:该院全身性使用氨基糖苷类抗感染药物的临床应用总体较为合理,但仍存在用药剂量不精确、联合用药不合理等问题,应在治疗药物监测的指导下合理用药,并在用药期间密切关注肾功能相关指标的变化。OBJECTIVE:To investigate the application of aminoglycoside anti-infective drugs in inpatients,so as to promote rational drug use in clinic.METHODS:Demographic data,drug administration,pathogen examination,drug combination,and adverse drug reactions of inpatients with systemic aminoglycosides anti-infective drugs in the hospital from Jan.1st to Jun.1st,2023 were retrospectively analyzed.RESULTS:A total of 360 inpatients were treated with amikacin,etimicin,and gentamicin during this period.There were 251 male patients and 109 female patients with an average age of 69.1 years.Aminoglycoside anti-infective drugs were mainly used in the treatment of Gram-negative bacterial infection,and were mostly combined withβ-lactam drugs.Among 202 patients treated with medication,the effective rate was 91.09%(184/202).Serum creatinine of 25 patients increased significantly after treatment(6.94%).Totally 133 patients had irrational medication,including 24 cases of irrational dosage(18.05%),39 cases of improper drug combination(29.32%),52 cases of irrational prophylactic medication regimen(39.10%),25 cases of irrational timing of perioperative medication(18.80%),and 12 cases of irrational selection of prophylactic medication(9.02%).CONCLUSIONS:The clinical application of aminoglycoside anti-infective drugs in the hospital is generally rational,yet there are still some problems such as inaccurate dosage and irrational drug combination.Rational medication should be guided by therapeutic drug monitoring,and the changes of related indicators of renal function should be paid close attention during drug use.

关 键 词：氨基糖苷类药物 抗感染药物 合理用药 回顾性分析 

分 类 号：R978.12[医药卫生—药品]