血清降钙素原检测联合抗菌药物分级管理指导医院抗菌药物应用的效果

Effect of serum procalcitonin test combined with hierarchical management of antibiotics on antibacterial usage in hospital

目的探讨血清降钙素原(PCT)检测联合抗菌药物分级管理指导医院抗菌药物应用的效果。方法选取吴川市人民医院2018年1月至2018年12月住院患者需用抗菌药物治疗的400例患者作为研究对象,随机分为两组,每组200例。对照组根据常规实验室检查及抗菌药物分级管理进行抗菌药物的使用,观察组在对照组的基础上连续监测血清PCT进行抗菌药物的使用,对比两组患者抗菌药物使用率、病原菌耐药率,统计两组病原菌占比情况,并观察主要病原菌对常用抗菌药物的耐药率。结果观察组抗菌药物使用率、病原菌耐药率均低于对照组,差异有统计学意义(P<0.05)。观察组铜绿假单胞菌(44.00%)、肺炎克雷伯菌(20.00%)、金黄色葡萄球菌(24.00%)、溶血葡萄球菌(8.00%)与对照组(33.75%、22.50%、25.00%、18.75%)比较,差异未见统计学意义(P>0.05)。观察组铜绿假单胞菌对哌拉西林/他唑巴坦耐药率(18.18%)、肺炎克雷伯菌对头孢哌酮/舒巴坦耐药率(20.00%)、金黄色葡萄球菌对青霉素G耐药率(16.67%)、溶血葡萄球菌对氧氟沙星耐药率(0.00)均低于对照组(55.56%、72.22%、65.00%、73.33%),差异有统计学意义(P<0.05)。结论血清PCT检测联合抗菌药物分级管理能够减少抗菌药物的使用,有效控制医院感染,同时还可以降低感染病原菌耐药性。

Objective To investigate the effect of serum procalcitonin(PCT)detection combined with antimicrobial classification management on antibacterial usage in hospital.Methods Four hundred hospitalized patients in Wuchuan People’s Hospital from January 2018 to December 2018 who needed antimicrobial treatment were selected as the research objects and randomly divided into two groups,with 200 cases in each group.The control group used antibiotics according to the routine laboratory examination and antimicrobial hierarchical management.The observation group continuously monitored the serum PCT for the use of antibiotics on the basis of the control group.The use rate of antibacterial drugs and the drug resistance rate of pathogenic bacteria were compared between the two groups.The proportion of pathogenic bacteria in the two groups was counted,and the drug resistance rate of main pathogenic bacteria to commonly used antibiotics was observed.Results The use rate of antibiotics and drug resistance rate of pathogenic bacteria in the observation group were lower than those in the control group,the differences were significant(P<0.05);the Pseudomonas aeruginosa(44.00%),Klebsiella pneumoniae(20.00%),Staphylococcus aureus(24.00%),Staphylococcus haemolyticus(8.00%)in the observation group and the control group(33.75%,22.50%,25.00%and 18.75%)had no significant difference(P>0.05).The drug resistance rate of Pseudomonas aeruginosa to piperacillin/tazobactam(18.18%),Klebsiella pneumoniae to Cefoperazone/sulbactam(20.00%),Staphylococcus aureus to penicillin G(16.67%)and Staphylococcus haemolyticus to ofloxacin(0.00%)were lower than those of the control group(55.56%,72.22%,65.00%and 73.3%),the differences were significant(P<0.05).Conclusions Serum PCT test combined with antimicrobial classification management can reduce the use of antibiotics,effectively control hospital infection,and reduce the drug resistance of pathogens.