耐甲氧西林金黄色葡萄球菌感染79例抗菌药物临床应用分析

Clinical analysis on antibacterial use in seventy-nine cases of methicillne-resistant Staphylococcus aureus infection

目的探求控制耐甲氧西林金黄色葡萄球菌(MRSA)感染的抗菌药应用现状,以利于指导临床合理用药。方法对79例确认病例进行用药全程的回顾性分析;统计各品种对MRSA的敏感度及不同时段的用药频度变化。结果79例MRSA感染病例,涉及用药35种,平均每例用药24.5d、6.65种、药费10840元。药敏试验前使用对MRSA敏感品种不足40%,但却占用药天数和品种数的70%。药敏结果报告后,用药准确率可达90%以上。万古霉素类仍为目前对MRSA最敏感(100%)和使用最多(55%)的品种。结论及早进行MRSA的分离确认和药敏试验,对缩短疗程、节省抗生素资源及药费,均有积极的指导意义。

Objective To make a survey of current situation of antibacterial use for controlling the methicillin-resistant Staphylococcus aureus(MRSA) infection,so as to guide the clinical reasonable use of these drugs.Methods A retrospective analysis on the whole course of medication was made among 79 cases;the MRSA susceptivity to various antibacterial drugs,and their medication frequency in different stages were also recorded statistically.Results Seventy-nine MRSA-infecting cases were given 35 antibacterial drugs,averaging 6.65 kinds of drugs and 24.5 days for each case,charging 10 840 yuan(CNY) for each.Antibacterial use without prior sensitive test got only 40% or less of these drugs effective to MRSA,but accounting for 70% of medication days and kinds totally;contrarily the antibacterial use with prior sensitive test got 90% or more of drugs effective to MRSA.Vancomycin is still one of the most MRSA-sensitive(100%) and most wide-used(55%) antibiotics.Conclusion Timely doing the strain isolation and identification of MRSA plays a guiding role in shortening treatment course,saving on antibiotics,and cutting down expenses.