碳青霉烯类抗菌药物临床应用及不合理用药的影响因素分析  

Analysis of clinical application of carbapenem antibacterial drugs and influencing factors of irrational drug use

作　　者：蒋菲 魏冰欣 JIANG Fei;WEI Bingxin(The Affiliated Changzhou No.2 People's Hospital,Changzhou 213000,Jiangsu China)

机构地区：[1]常州市第二人民医院,江苏常州213000

出　　处：《中国病原生物学杂志》2025年第3期333-337,共5页Journal of Pathogen Biology

摘　　要：目的探析本院碳青霉烯类抗菌药物临床应用情况、不合理用药原因及相关影响因素。方法通过本院院内电子信息系统,抽取358例使用碳青霉烯类抗菌药物治疗住院患者为本次研究对象,通过患者及主治医师相关资料,分析使用患者科室分布情况、用药前病原学送检情况、不合理用药原因及相关影响因素。结果在358例使用碳青霉烯类抗菌药物的患者中,呼吸与危重症医学科占28.77%,重症医学科占20.95%,血液肿瘤科占11.73%,老年病科占10.61%,神经外科占6.42%,消化内科占4.75%,肾内科占4.19%,泌尿外科占3.63%,神经内科占3.07%,肝胆内科占2.51%,感染科占1.96%,儿科占1.4%。322例在使用碳青霉烯类药物前进行了病原菌检测,送检率为89.94%。各科室送检率如下:呼吸与危重症医学科88.35%,重症医学科96%,血液肿瘤科95.24%,老年病科92.11%,神经外科86.96%,消化内科88.24%,肾内科80%,泌尿外科76.92%,神经内科72.73%,肝胆内科88.89%,感染科85.71%,儿科100%。在322例送检标本中,135例检测出病原体,阳性率为41.93%,其中痰液标本的阳性率最高,为55.56%。135例病原学阳性标本中,共检出135株病原菌,主要包括肺炎克雷伯菌39株,大肠埃希菌25株,铜绿假单胞菌18株,鲍曼不动杆菌13株,产气肠杆菌10株,奇异变形杆菌9株,产酸克雷伯菌7株,阴沟肠杆菌7株,嗜麦芽窄食单胞菌5株,洋葱伯克霍尔德菌2株。肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、产气肠杆菌、嗜麦芽窄食单胞菌、洋葱伯克霍尔德菌对碳青霉烯类药物有不同程度的耐药性,而大肠埃希菌、奇异变形杆菌、产酸克雷伯菌、阴沟肠杆菌未发现耐药株。54例使用碳青霉烯类药物不合理,用药不合理率为15.08%。其中,30例患者使用特殊级抗菌药物前未有会诊记录,7例未做病原学检测,5例抗菌药物选择不当,4例适应症不适宜,3例用法、用量不当,3例联合用药不当,2例肾�Objective The clinical application status of carbapenem antibacterial drugs,reasons for irrational drug use and related influencing factors were analyzed in our hospita.lM.ethodsBy the hospital's electronic information system,358 inpatients treated with carbapenem antibacterial drugs were selected as the research objects for this study.By the relevant data of patients and attending physicians,the department distribution of users,the submission of etiological examination before medication,the reasons for irrational drug use and related influencing factors were analyzed.Results Among the 358 patients using carbapenem antibacterial drugs,the Department of Respiratory and Critical Care Medicine accounted for 28.77%,the Department of Critical Care Medicine accounted for 20.95%,the Department of Hematology and Oncology accounted for 11.73%,the Department of Geriatrics accounted for 10.61%,the Department of Neurosurgery accounted for 6.42%,the Department of Gastroenterology accounted for 4.75%,the Department of Nephrology accounted for 4.19%,the Department of Urology accounted for 3.63%,the Department of Neurology accounted for 3.07%,the Department of Hepatobiliary Medicine accounted for 2.51%,the Department of Infectious Diseases accounted for 1.96%,and the Department of Pediatrics accounted for 1.4%.322 cases had pathogen detection before using carbapenem drugs,and the submission rate was 89.94%.The submission rates of various departments were as follows:88.35%in the Department of Respiratory and Critical Care Medicine,96%in the Department of Critical Care Medicine,95.24%in the Department of Hematology and Oncology,92.11%in the Department of Geriatrics,86.96%in the Department of Neurosurgery,88.24%in the Department of Gastroenterology,80%in the Department of Nephrology,76.92%in the Department of Urology,72.73%in the Department of Neurology,88.89%in the Department of Hepatobiliary Medicine,85.71%in the Department of Infectious Diseases,and 100%in the Department of Pediatrics.Among the 322 submitted specimens,pathogens

关 键 词：碳青霉烯类抗菌药物 合理用药 影响因素 

分 类 号：R47[医药卫生—护理学]