烧伤病区抗菌药物使用9年的回顾性分析

Nine-year Use of Antibiotics in a Burn Unit: A Retrospective Analysis

目的分析烧伤抗感染治疗用药的变化趋势,为促进合理使用抗菌药物、提高临床抗感染治疗水平积累经验并提供参考。方法采用平均100例患者每日使用约定剂量(DDDs/100例.d)作为抗菌药物使用量的观察指标,对烧伤病区1995-2003年抗菌药物使用的数据进行统计,并统计同期病原菌不同革兰染色类型所占比例,作为评价抗菌药物使用合理性的参照。结果9年来烧伤临床抗菌药物使用量无明显增加的趋势,2003年含酶抑制剂类药物取代氨基糖苷类药物成为使用量最大的抗菌药物;1995年后革兰阳性菌在病原菌中所占比例逐渐升高,2003年已超过革兰阴性菌。结论烧伤病区对抗菌药物的使用实行了有效的总量控制;今后应重点加大对革兰阳性菌感染治疗的力度。

OBJECTIVE TO analyze the use of antibiotic METHODS The data of consumption of different kinds of in the burn unit of our hospital from 1995 to 2003. antibiotics and total antibiotic consumption [-expressed as the number of defined daily doses （DDD） per 100 patients per day], as well as the proportion of Gram positive and Gram negative bacteria in isolated strains from burn patients was calculated in a nine-year period. RESULTS The total consumption of combination of antibiotic and β-lactamase inhibitor （compound drugs） was increased gradually and ranked first among all kinds of antibiotics, but there was no trend of increase observed in total amount of consumption of antibiotics. The proportion of Gram positive bacteria was increased markedly, exceeding that of the Gram negative ones in 2003. CONCLUSIONS The measures to control total amount of consumption of antibiotics and to promote judicious use of antibiotics may be beneficial in the prevention and treatment of infections in the burn unit. To pay more attention on the prevention and treatment of Gram positive infection should be emphasized to mitigate the tendency of increase in Gram positive bacteria infection.