注射用左氧氟沙星的药物利用评价

发布时间：2018-11-10 07:09

【摘要】：目的:从横断面角度了解某院注射用左氧氟沙星的临床应用情况,为加强左氧氟沙星的临床应用管理和优化给药方案提供依据。方法:采用连续多点横断面法对某院2014年8月至2015年3月每月13日注射用左氧氟沙星的使用情况进行统计和分析,结合浓度依赖性抗菌药物PK/PD理论、左氧氟沙星特点和抗菌药物临床应用指导原则,分别从用药目的、用药剂量、感染部位和联合用药等方面评判其用药合理性。结果:一日一次给药方案为224例(43.41%),一日两次给药方案为292例(56.59%);日剂量0.6 g为251例(48.64%),日剂量0.4 g为78例(15.12%),日剂量0.3 g为162例(31.40%),日剂量0.2 g为25例(4.84%);患者肌酐清除率在20~49 mL·min-1区间的药物利用指数为1.61,肌酐清除率在10~19 mL·min-1区间的药物利用指数为1.67,大于65岁老年患者药物利用指数为1.56;无适应证用药73例(14.15%),其中非手术无适应证用药17例(3.29%);手术预防用药56例(10.85%);未考虑患者年龄、肾功能和感染部位,给药剂量过高39例(7.56%),给药剂量过低69例(13.37%);中枢神经系统感染用药17例(3.29%);同类药物联合用药10例(1.94%),无指征三/四联用药31例(6.01%)。210例患者用药存在问题,总的不合理使用率40.70%。结论:左氧氟沙星PK/PD理论适用于其临床应用评价,判断其临床应用的合理性还需综合考虑患者肾功能、感染部位和手术部位。
[Abstract]:Objective: to understand the clinical application of levofloxacin for injection in a hospital from a cross-sectional point of view, and to provide the basis for strengthening the clinical application management of levofloxacin and optimizing the regimen of administration of levofloxacin. Methods: the use of levofloxacin for injection in a hospital from August 2014 to March 13, 2015 was statistically analyzed by continuous multi-point cross-sectional method, combined with the PK/PD theory of concentration-dependent antimicrobial agents. The characteristics of levofloxacin and the guiding principles of clinical application of antimicrobial agents were evaluated in terms of the purpose, dosage, site of infection and combination of antibiotics. Results: 224 cases (43.41%) were treated once a day and 292 cases (56.59%) were administered twice a day. The daily dose of 0.6 g was 251 cases (48.64%), the daily dose of 0.4 g was 78 cases (15.12%), the daily dose of 0.3 g was 162 cases (31.40%), the daily dose of 0.2 g was 25 cases (4.84%). The drug utilization index of patients with creatinine clearance in the range of 20 ~ 49 mL min-1 was 1.61.The drug utilization index of patients with creatinine clearance at 1019 mL min-1 was 1.67, which was higher than that of the aged patients aged 65 years. There were 73 cases (14.15%) without indications, 17 cases (3.29%) with non-operative indications, 56 cases (10.85%) with surgical prophylaxis. 39 cases (7.56%) were overdosed, 69 cases (13.37%) were given too low dose, 17 cases (3.29%) were treated with central nervous system infection. There were 10 cases (1.94%) with the same drug combination and 31 cases (6.01%) with no indication of combined use of three or four drugs. 210 patients had problems with the use of drugs, and the total irrational utilization rate was 40.70%. Conclusion: levofloxacin PK/PD theory can be used to evaluate the clinical application of levofloxacin. It is necessary to consider the renal function, site of infection and site of operation in order to judge the rationality of the clinical application of levofloxacin.
【作者单位】：蚌埠医学院第一附属医院药剂科;蚌埠医学院第一附属医院呼吸与危重症医学科;
【基金】：安徽省教育厅2014年度高等教育振兴计划人才项目[皖教秘人(2014)181号] 安徽省教育厅2016年度高校领军人才引进与培育计划项目[皖教秘人(2015)211号]
【分类号】：R978.1

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