某院2013-2016年抗菌药物眼用制剂使用量与眼部感染细菌耐药性分析

发布时间：2018-04-09 08:18

本文选题：眼用制剂　切入点：抗菌药物　出处：《中国药房》2017年26期

【摘要】：目的:为临床合理选用抗菌药物眼用制剂提供参考。方法:汇总、分析某院2013年1月-2016年12月抗菌药物眼用制剂的使用情况,计算其用药频度(DDDs);收集细菌培养、鉴定及药敏试验结果,采用Pearson检验考察抗菌药物眼用制剂DDDs与细菌耐药率的相关性。结果:2013-2016年,该院使用的抗菌药物眼用制剂共计七大类10个品种,总DDDs呈上升趋势,年均增长率为26.16%。妥布霉素(地塞米松)滴眼液的DDDs连续3年(2013-2015年)最高,加替沙星滴眼液/眼用凝胶、氧氟沙星滴眼液/眼膏的DDDs在第2~4位波动。共送检眼部标本26 143份,检出细菌21种,共6 221株,检出率为23.80%。检出率最高的前3种细菌分别为表皮葡萄球菌(3 067株)、肺炎链球菌(470株)、金黄色葡萄球菌(321株)。上述3种细菌对红霉素的耐药率均在70%以上,而对利福平、氯霉素、庆大霉素、左氧氟沙星等药物较为敏感。利福平(2015年)、庆大霉素(2015、2016年)、四环素(2015年)、氧氟沙星(2014、2015年)、左氧氟沙星(2016年)、加替沙星(2016年)的平均耐药率与上一年比较,差异均有统计学意义(P0.05)。四环素的DDDs与其平均耐药率呈正相关(r=1.000,P0.05);而其他抗菌药物的DDDs与耐药率无关(P0.05)。结论:该院患者眼部感染以表皮葡萄球菌、肺炎链球菌、金黄色葡萄球菌为主;四环素的DDDs与耐药率之间存在一定的相关性。规范抗菌药物眼用制剂的临床使用对延缓细菌耐药性的发展具有重要意义。
[Abstract]:Objective: to provide reference for the rational selection of antimicrobial ophthalmic preparations in clinic.Methods: from January 2013 to December 2016, the use of antimicrobial ophthalmic preparations in a hospital was analyzed, the frequency of drug use was calculated, and the results of bacterial culture, identification and drug sensitivity tests were collected.Pearson test was used to investigate the correlation between antimicrobial eye preparation DDDs and bacterial resistance rate.Results from 2013 to 2016, 10 kinds of antimicrobial agents were used in the hospital, and the total DDDs showed an increasing trend, with an average annual growth rate of 26.16%.The DDDs of tobramycin (dexamethasone) eye drops was the highest for 3 consecutive years (2013-2015). The DDDs of gatifloxacin eye drops / eye gels and ofloxacin eye drops / ointment fluctuated in the second fourth position.A total of 26 143 eye specimens were collected, 21 species of bacteria were detected, 6 221 strains were detected, and the detection rate was 23.80%.The highest detection rate of the first three bacteria were Staphylococcus epidermidis 3067, Streptococcus pneumoniae 470, Staphylococcus aureus 321.The resistance rate of the three bacteria to erythromycin was over 70%, but sensitive to rifampicin, chloramphenicol, gentamicin and levofloxacin.The average resistance rates of rifampicin (2015), gentamycin (Gentamycin) 2015, tetracycline (2015), ofloxacin (2015), levofloxacin (2016) and gatifloxacin (2016) were significantly higher than those of the previous year (P 0.05).The DDDs of tetracycline was positively correlated with the average drug resistance rate, while the DDDs of other antimicrobial agents had no correlation with the drug resistance rate.Conclusion: Staphylococcus epidermidis, Streptococcus pneumoniae and Staphylococcus aureus are the major ocular infections in our hospital, and there is a certain correlation between tetracycline DDDs and drug resistance rate.It is important to regulate the clinical use of antimicrobial ophthalmic agents to delay the development of bacterial drug resistance.
【作者单位】：郑州市第二人民医院药务科;郑州市第二人民医院眼科;郑州市第二人民医院检验科;
【基金】：常州四药临床药学科研基金项目(No.CZSYJJ15013)
【分类号】：R988.1

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