某院2023年630例患者碳青霉烯类药物使用合理性评价  

Evaluation of the rationality of carbapenem use in 630 patients in a certain hospital in 2023

作　　者：栾晶晶 LUAN Jing-jing(Pharmacy Department,Sunshine Ronghe Hospital,Weifang 261072,China)

机构地区：[1]阳光融和医院药学部,261072

出　　处：《中国实用医药》2025年第7期142-145,共4页China Practical Medicine

摘　　要：目的分析碳青霉烯类药物临床使用情况,旨在促进其合理使用。方法回顾性分析某三甲医院2023年使用碳青霉烯类药物治疗的630例患者的病历资料,对碳青霉烯类药物的临床应用情况、病原学检查、不同科室使用情况进行汇总,通过患者药物选择、用法用量评估碳青霉烯类药物使用合理性,分析碳青霉烯类药物用药不合理情况。结果630例使用碳青霉烯类药物治疗的患者中,注射用亚胺培南西司他丁钠、注射用美罗培南和注射用比阿培南的抗菌药物使用强度(AUD)分别为0.58、0.22和0.03。630例患者中有527例患者进行微生物送检,微生物送检率为83.65%;527例患者中检测出病原菌的患者有114例,检出阳性率为21.63%,其中病原菌检出前3位分别为肺炎克雷伯菌(38.60%)、大肠埃希菌(31.58%)和铜绿假单胞菌(14.04%)。碳青霉烯类药物主要应用在血液内科(37.46%)、重症医学科(15.71%)、呼吸内科(5.56%)、心脏外科(4.29%)、医养中心(4.29%)。630例患者不合理用药率为31.43%,包括无会诊病程记录或记录不规范118例(18.73%)、药物选择不合理27例(4.29%)、未作疗效评估21例(3.33%)及其他(联合用药不合理、细菌感染未确诊、用法用量不适宜、适应证不适宜等)32例(5.08%)。结论某三甲医院2023年碳青霉烯类药物临床使用还有一定的不足,建议继续加强对碳青霉烯类药物临床应用的干预,提高临床合理用药水平,降低细菌耐药性。Objective To analyze the clinical use of carbapenems and promote their rational use.Methods A retrospective analysis was conducted on the medical records of 630 patients treated with carbapenems in a tertiary hospital in 2023.The use of carbapenems,pathogen examinations,and use in different departments were summarized.The rationality of carbapenem use was evaluated through patient drug selection,usage,and dosage,and the unreasonable use of carbapenems was analyzed.Results In 630 patients treated with carbapenems,the antimicrobial use density(AUD)of imipenem and cilastatin sodium for injection,meropenem for injection,and biapenem for injection were 0.58,0.22,and 0.03,respectively.Out of 630 patients,527 underwent microbiological testing,with a microbiological testing rate of 83.65%;among 527 patients,114 cases were detected with pathogenic bacteria,with a positive rate of 21.63%,among which the top three pathogens were Klebsiella pneumoniae(38.60%),Escherichia coli(31.58%)and Pseudomonas aeruginosa(14.04%);carbapenems were mainly used in hematology(37.46%),critical care medicine(15.71%),respiratory medicine(5.56%),cardiac surgery(4.29%),and medical nursing centers(4.29%);the rate of irrational drug use was 31.43%,mainly due to the lack of consultation course records or non-standard records(118 cases,18.73%),followed by unreasonable drug selection(27 cases,4.29%),no efficacy evaluation(21 cases,3.33%),and others(irrational combination of drug use,undiagnosed bacterial infection,inappropriate usage and dosage,inappropriate indications,32 cases,5.08%).Conclusion There are still certain shortcomings in the clinical use of carbapenems in a tertiary hospital in 2023.It is recommended to continue to strengthen intervention in the clinical application of carbapenems,improve the rationality of clinical medication,and reduce bacterial resistance.

关 键 词：碳青霉烯类药物 用药合理性 临床应用 

分 类 号：R978.1[医药卫生—药品]