抗生素治疗医院感染124例临床评价

Clinical Evaluation of Appropriate use of Antibiotics in 124 Patients with Nosocomial Infections

1994年6月随机抽取了全部出院(包括死亡)病案1312份,其中医院内感染124例,168例次.对此124例医院感染应用抗生素情况进行临床评价.评价标准按我们课题组制订的标准进行.医院感染最常见的部位主要是下呼吸道感染59例次(35.12%)、泌尿道感染20例次(12.50%)、胃肠道感染19例次(11.31%)和上呼吸道感染19例次(11.31%).医院感染124例总共培养出致病菌89株.124例医院感染共应用抗生素572个疗程,3981天.抗生素应用合理的237个疗程(占41.44%);应用基本合理的154个疗程(占29.62%);应用不合理的181个疗程(31.64%).应用不合理的主要原因是无应用抗生素的适应证(52.17%)和给药时间太长(28.80%).结论是合理应用抗生素首先应强调要严格掌握使用抗生素的适应证.当前提高抗生素合理应用水平,必须加强管理力度.

One hundred twenty-four patients with nosocomial infections (NI) selected from 1312 patients hospitalized in June 1994 were studied. The use of antibiotics in the 124 cases of NI were evaluated a-gainst a self-set standard. The most common sites of NI were lower respiratory tract (59 times, 35-12%), urinary tract(20 times, 12-50%), gastrointestinal tract(19 times, 11.31%)and upper respiratory tract(19 times, 11. 31%) in the 124 NI patients with total infection times being 68 times. 89 strains of bacteria were i-dentified by cultures in 124 patients with NI. in 572 therapeutic courses (3981 days) of antibiotics received by the 124 patients with NI, 237(41.44%) courses were judged to be appropriate; 154(26.92%) to be fairly appropriate and 181(31.64%) to be inappropriate. The inappropriate use included use of antibiotics for patients without indication (52.17%) and over-protracted use (28.80%). It is concluded that appropriate use of antibiotics lies in the strict identification of indications for antibiotic therapy. The regulations on the use of antibiotics has to be toughened.