住院患者多糖肽类抗生素临床应用分析与评价

发布时间：2018-11-28 09:32

【摘要】：目的探讨多糖肽类抗生素在住院患者中的临床应用情况,评价其用药合理性,为临床合理用药提供参考依据。方法采用回顾性调查方法调查某院2014年1—12月使用多糖肽类抗生素的住院患者,记录其相关临床资料。结果共纳入病例727例,其中感染患者471例(占64.79%)。社区感染与医院感染均以呼吸道为主(分别占39.17%、45.98%)。多糖肽类抗生素用药天数平均6.06 d(4 403/727)。重症监护病房(ICU)、肿瘤科及神经外科患者使用例数最多,分别为148例(20.36%)、88例(12.10%)、81例(11.14%)。单用糖肽类患者338例(46.49%),联用种类平均达4.43种,三联及以上达99例(13.62%),联用频率最高的为第二代头孢菌素类(20.48%)。多糖肽类抗生素中使用万古霉素450例(61.90%),使用替考拉宁260例(35.76%),万古霉素与替考拉宁同用17例(2.34%)。共分离病原体847株,主要为鲍曼不动杆菌(111株,13.10%)、肺炎克雷伯菌(80株,9.45%)、铜绿假单胞菌(68株,8.03%)及金黄色葡萄球菌(54株,6.37%),其中耐甲氧西林金黄色葡萄球菌50株。经多糖肽类抗生素治疗后有效490例,有效率为67.40%。727例患者中,用药合理86例(11.83%),基本合理315例(43.33%),不合理326例(44.84%)。结论该院多糖肽类抗生素使用情况基本合理,但对适应证的把握有待加强。
[Abstract]:Objective to investigate the clinical application of polyglycopeptide antibiotics in inpatients and to evaluate the rationality of the use of polyglycopeptide antibiotics. Methods A retrospective survey was conducted to investigate the clinical data of patients who used polyglycopeptide antibiotics in a hospital from January to December 2014. Results A total of 727 cases were included, of which 471 cases (64.79%) were infected. Respiratory tract was the main infection in community and hospital (39.17% and 45.98% respectively). The average duration of administration of polyglycopeptide antibiotics was 6.06 days (4403 / 727). (ICU), oncology and neurosurgery were the most frequently used cases in intensive care unit, which were 148 cases (20.36%), 88 cases (12.10%) and 81 cases (11.14%) respectively. 338 cases (46.49%) were treated with glycopeptide alone, with an average of 4.43 kinds of combined use, 99 cases (13.62%) of triple use and above, and the second generation cephalosporins (20.48%). Among the polyglycopeptide antibiotics, 450 cases (61.90%) were treated with vancomycin, 260 cases (35.76%) with teicoplanin, 17 cases (2.34%) with both vancomycin and teicoplanin. A total of 847 strains of pathogens were isolated, including Acinetobacter baumannii (111, 13.10%), Klebsiella pneumoniae (80, 9.45%), Pseudomonas aeruginosa (68, 8.03%) and Staphylococcus aureus (54, 6.37%). Among them, 50 strains of methicillin-resistant Staphylococcus aureus were isolated. In 490 patients treated with polyglycopeptide antibiotics, the effective rate was 67.40.727 cases, 86 cases (11.83%) were reasonable, 315 cases (43.33%) were reasonable, 326 cases (44.84%) were unreasonable. Conclusion the use of polyglycopeptide antibiotics in our hospital is basically reasonable, but the indication needs to be strengthened.
【作者单位】：第三军医大学大坪医院野战外科研究所重庆市感染控制中心;
【分类号】：R95

【相似文献】