我院2013-2014年720例使用万古霉素患者临床用药分析

发布时间：2018-11-04 11:05

【摘要】：目的:为促进万古霉素的临床合理使用提供参考。方法:参照万古霉素药品说明书、《抗菌药物临床应用指导原则(2015年版)》和《万古霉素临床应用中国专家共识(2011版)》等,抽取我院2013年1月-2014年12月共720份使用万古霉素的住院患者病历,就其用药情况进行回顾性分析。结果:720例患者中男性(428例)多于女性(292例),以41~65岁患者居多(45.83%);预防用药50例(6.94%),治疗用药670例(93.06%),患者分布于36个科室;720例患者中19例给药剂量2 g/d,发生不良反应的有13例(1.81%);670例治疗用药病例中微生物检验样本送检587例(87.61%),且有522例(77.91%)联合使用了其他抗菌药物;549例≥18岁的治疗用药病例万古霉素药物利用指数(DUI)=0.96;用药不适宜病例共240例(33.33%),其中溶媒使用不适宜192例(26.67%),用法用量不适宜28例(3.89%),联合用药不适宜20例(2.78%)。结论:我院万古霉素总体应用基本合理,使用科室分布较广,联合用药现象较为普遍,微生物检验样本送检率合格,不存在滥用现象,但其临床使用过程中仍存在某些不适宜情况。应加强万古霉素合理使用的专项点评与培训,进一步规范万古霉素的用药监护,以保障患者的用药安全。
[Abstract]:Objective: to provide reference for the rational use of vancomycin in clinic. Methods: according to the vancomycin drug specification, the guidelines for clinical application of antimicrobial agents (2015) and the consensus of Chinese experts on the clinical application of vancomycin (2011), etc. From January 2013 to December 2014, 720 medical records of inpatients with vancomycin were collected and analyzed retrospectively. Results: among 720 patients, 428 cases were male (428 cases) more than 292 female (45.83%), 50 cases (6.94%) were prophylaxis, 670 cases (93.06%) were treated with prophylaxis and 670 cases (93.06%), the patients were distributed in 36 departments. Of the 720 patients, 19 were given 2 g / d, 13 (1.81%) had adverse reactions. Of the 670 cases, 587 (87.61%) were examined by microbiological examination, and 522 (77.91%) were treated with other antimicrobial agents. The vancomycin utilization index (DUI) was 0.96 in 549 patients aged more than 18 years. 240 cases (33.33%) were not suitable for drug use, among which 192 cases (26.67%) were not suitable for solvent use, 28 cases (3.89%) were not suitable for use of solvent, and 20 cases (2.78%) were not suitable for combined use. Conclusion: the general application of vancomycin in our hospital is reasonable, the use of vancomycin is widely distributed in departments, the phenomenon of combined use of drugs is relatively common, the rate of microbiological examination samples is qualified, and there is no phenomenon of abuse. However, there are still some inappropriate conditions in clinical use. Special comments and training on the rational use of vancomycin should be strengthened so as to further standardize the monitoring of vancomycin use in order to ensure the safety of patients in the use of vancomycin.
【作者单位】：吉林大学第一医院药学部
【分类号】：R978

【参考文献】