应用儿童药物利用指数评价新生儿科头孢哌酮钠舒巴坦钠用药合理性  

Evaluation of the rationalality of cefoperazone-sulbactam in neonatal department based on children drug utilization index

作　　者：宣勤 陶柏成[2] XUAN Qin;TAO Baicheng(Department of Neonatology,Suzhou Hospital(Suzhou Science and Technology Town Hospital),Affiliated Hospital of Medical School,Nanjing University,Jiangsu Suzhou 215153,China;Department of Pharmacy,Children's Hospital Afiliated to Soochow University,Jiangsu Suzhou 215025,China)

机构地区：[1]南京大学医学院附属苏州医院(苏州科技城医院)新生儿科,江苏苏州215153 [2]苏州大学附属儿童医院药剂科,江苏苏州215025

出　　处：《临床药物治疗杂志》2024年第S1期87-91,共5页Clinical Medication Journal

摘　　要：目的 应用儿童药物利用指数(cDUI)考察南京大学医学院附属苏州医院新生儿科注射用头孢哌酮钠舒巴坦钠的使用情况,为新生儿用药的合理优化提供参考。方法 抽取2023年该院全年74例应用头孢哌酮钠舒巴坦钠的新生儿资料,通过计算cDUI,判断其药物应用的合理性,并分析头孢哌酮钠舒巴坦钠的应用与胎龄、日龄、联合用药、用法用量、白细胞计数、C-反应蛋白值,以及中性粒细胞比率之间的相关性。结果 在纳入的74例新生儿样本中,早产儿26例、足月儿48例,不同胎龄组cDUI的比较差异无统计学意义(P>0.05);70例围生期新生儿(94.29%)与4例围生期外新生儿(5.71%)的cDUI比较显示,cDUI随日龄增加而增长的线性趋势不明显;55例新生儿(74.32%)为头孢哌酮钠舒巴坦钠与注射用青霉素钠联合使用,19例新生儿(25.68%)为头孢哌酮钠舒巴坦钠单独使用,两组间cDUI的比较差异无统计学意义(P>0.05);其中21例新生儿(28.38%)用药剂量为30~60 mg/(kg·d),53例新生儿(71.62%)用药剂量>60 mg/(kg·d),最大用药剂量为92 mg/(kg·d),均为每12 h用药1次,两组间cDUI的比较差异有统计学意义(P<0.05);入组的样本中,有19例新生儿(25.68%)为0.9≤cDUI≤1.1,12例(16.22%)cDUI<0.9,43例(58.10%)cDUI>1.1;白细胞计数、C-反应蛋白值,以及中性粒细胞比率对cDUI值均无显著性影响。结论 除用法用量外,胎龄、日龄、联合用药、白细胞计数、C-反应蛋白值,以及中性粒细胞比率对cDUI值均无显著影响;入组的样本中存在头孢哌酮钠舒巴坦钠用量过小或过大的情况,提示该院新生儿科头孢哌酮钠舒巴坦钠的应用存在不合理现象。Objective To investigate the use of cefoperazone-sulbactam for injection in the neonatal department of a hospital using the children's drug utilization index(children drug utilization index,cDUI)and provide areference for optimizing neonatal drug utilization.Methods We extracted data from 74 neonates who received cefoperazone-sulbactam in 2023.The cDUI was calculated to determine drug utilization rationality,and the relationship between cefoperazone-sulbactam use and factors such as gestational age,postnatal age,combination therapy,dosage,white blood cell count,C-reactive protein value,and neutrophil ratio.Results Among the 74 neonates,26 were premature infants and 48 were full-term.There was no statistically significant difference in cDUI values across different gestational age groups(P>0.05).A comparison of cDUI between 70 perinatal neonates(94.29%)and 4 non-perinatal neonates(5.71%)showed no significant linear trend in cDUI with increasing age.Fifty-five neonates(74.32%)received combination therapy with cefoperazone-sulbactam and penicillin sodium,while 19(25.68%)received cefoperazone-sulbactam alone,with no significant difference in cDUI between these groups(P>0.05).Dosages were 30–60 mg/(kg·d)for 21 neonates(28.38%)and>60 mg/(kg•d)for 53 neonates(71.62%),with a maximum dosage of 92 mg/(kg·d),administered every 12 hours.The difference in cDUI between these dosage groups was statistically significant(P<0.05).Among the enrolled neonates,19(25.68%)had cDUI values within 0.9–1.1,12(16.22%)had cDUI<0.9,and 43(58.10%)had cDUI>1.1.White blood cell count,CRP level,and neutrophil ratio showed no significant effect on cDUI values.Conclusion Gestational age,postnatal age,combination therapy,white blood cell count,C-reactive protein value,and neutrophil ratio had no significant effect on cDUI value,except for dosage.There were instances of suboptimal or excessive dosing of cefoperazone-sulbactam among the neonates,indicating potential irrationality in its application in the neonatal department.

关 键 词：儿童药物利用指数 新生儿 头孢哌酮钠舒巴坦钠 用药合理性评价 

分 类 号：R978.11[医药卫生—药品] R969.3[医药卫生—药学]