浅议控制泰能使用的管理体会

Management of control of imipenem/cilastatin application

目的采取有效措施控制不合理使用碳青霉烯类抗生素亚胺培南/西司他丁(泰能)。方法医院成立“抗菌药物合理应用指导小组”,须经该组专家批准,临床科室方可使用泰能。结果2004年10月-2005年12月使用泰能的量比2004年1-9月减少64瓶。批准使用泰能的20例患者均为严重感染,其中11例为经验性用药,9例有细菌学证据。医院分离的部分铜绿假单胞菌、醋酸钙/鲍曼不动杆菌仅对亚胺培南敏感。已发现耐亚胺培南菌株。结论严格控制泰能使用可提高其治疗的针对性,提高疗效,延长其使用时间。

Objective To adopt effective measures to control the inappropriate application of carbapenems imipenem/cilastatin （imipenem）. Methods ＂Antimicrobial rational application guidance group＂ was established by a hospital, imipenem could be used only through ratification of the group. Results From October 2004 to December 2005, the amount of imipenem was reduced by 64 bottles compared with that from January to September 2004, 20 patients receiving imipenem had serious infection, 11 of whom received eanpirieal usage, 9 used imipenem based on bacterial evidence. Part of clinical isolated Pseudomonas aeruginosa andAcinetobacter calcoaceticus/baumannii were only sensitive to imipenem. Imipenern-resistant bacterial strains were found. Conclusion Strict control of application of imipenem can improve therapeutic effect and prolong the application period.