我院2013-2015年慢性阻塞性肺疾病急性加重期抗菌药物利用评价

发布时间：2018-08-31 20:47

【摘要】：目的:评价慢性阻塞性肺疾病急性加重期(AECOPD)住院患者使用抗菌药物的有效性、安全性和经济性,以促进抗菌药物的合理使用。方法:采用回顾性研究方法,以2013-2015年度为评价时间段,以主要诊断为AECOPD的住院患者为研究对象,评价其抗菌药物利用情况。结果:纳入本研究的AECOPD患者共3 186人次,抗菌药物使用率在90%以上。注射用头孢地嗪钠的用药频度(DDDs)在3年中连续排在第1位,但在2015年有所下降;而含酶的β-内酰胺类和碳青霉烯类抗菌药物的DDDs有所上升。日均费用(DDC)以注射用美罗培南和注射用亚胺培南西司他丁钠最高。药物利用指数(DUI)远大于1.0的有注射用头孢地嗪钠,远小于1.0的有注射用哌拉西林钠舒巴坦钠。注射用头孢地嗪钠的排序比(B/A)在3年中都介于1~2之间,注射用哌拉西林钠舒巴坦钠、注射用亚胺培南西司他丁钠、注射用美罗培南的B/A都小于1.0。结论:我院AECOPD患者的抗感染治疗适应证掌握较为严格,抗菌药物使用率在逐年下降,抗菌药物的品种选择较为合理,药物利用基本合理的抗菌药物数量在逐年增加,但注射用头孢地嗪钠、注射用哌拉西林钠舒巴坦钠的药物利用合理性还有待提高。
[Abstract]:Objective: to evaluate the efficacy, safety and economy of using antibiotics in (AECOPD) patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) in order to promote the rational use of antimicrobial agents. Methods: retrospective study was used to evaluate the use of antimicrobial agents in patients with AECOPD in 2013-2015. Results: a total of 3 186 AECOPD patients were included in this study, and the antimicrobial use rate was over 90%. The frequency of cefdiazine sodium for injection was ranked first in three years, but decreased in 2015, while the DDDs of 尾 -lactam and carbapenem antibiotics with enzyme increased. The daily average cost (DDC) of meropenem for injection and imipenem sodium for injection were the highest. The drug utilization index (DUI) was far greater than 1. 0 for cefdiazine sodium for injection, and for piperacillin sodium for injection and sulbactam sodium for injection. The sequence ratio (B / A) of cefdiazine sodium for injection (B / A) was between 1 and 2 in 3 years, piperacillin sodium for injection and sulbactam sodium for injection, imipenem for injection and meropenem for injection were all less than 1.0. Conclusion: the indications of anti-infective therapy for AECOPD patients in our hospital are strict, the utilization rate of antimicrobial agents is decreasing year by year, the variety selection of antimicrobial agents is more reasonable, and the number of antimicrobial agents whose use is basically reasonable is increasing year by year. However, the rationality of cefdiazine sodium for injection and piperacillin sodium for injection for sulbactam still needs to be improved.
【作者单位】：南方医科大学附属小榄医院药剂科;
【基金】：中山市科技计划项目社会发展攻关计划(医疗)(No.2015B1237)
【分类号】：R563.9

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