临床药师参与227例抗菌药物应用会诊情况分析与思考

Perspectives on Clinical Pharmacists' Participating in Consultation on the Use of Antibiotics in 227 Cases

目的:探讨临床药师参与临床会诊的方法及作用。方法:对某院2004年2月～2007年12月临床药师参与227例抗菌药物应用会诊情况,包括患者基本情况、会诊原因、病原菌、继往用药史、会诊建议是否被采纳、病情反馈等进行分析。结果:临床药师参与抗菌药物应用会诊例数由2004年的7例上升至2007年的123例;其中,内科患者≥42.8%;患者男女性别比约为2∶1;年龄、外周血象、体温基本情况无显著性差异(P<0.01);≥57.1%的患者进行了药敏试验或有药敏结果。会诊原因以指导用药为主,也有指定选药情况;≥50.0%的患者曾应用第3代头孢菌素及其加酶制剂;临床药师的会诊建议被采纳的比例逐年上升,2007年达92.7%。≥42.9%的患者病情好转。结论:临床药师在针对抗菌药物选用、应用方法、注意事项等方面为医师提供了一定帮助,但未能做到事前进行用药干预,其工作方式有待进一步改进。

OBJECTIVE： To discuss the approach and role of clinical pharmacists＇ participating in clinical consultation. METHODS： The consultation data of clinical pharmacists＇ participating in clinical consultation from Feb. 2004 to Dec. 2007 including patients＇ basic condition, reasons for consultation, pathogens, past medication history, whether the consultative suggestions were adopted or not, feedback of patient＇ s condition etc were analyzed. RESULTS： Clinical pharmacists partici- pated in clinical consultation for 7 cases on the use of antibiotics in 2004, up to 123 cases in 2007. Of which, the patients from internal medicine department accounted for no less than 42.8% ; the ratio of male to female was about 2： 1. No significant differences were noted in age, peripheral hemogram and body temperature（P〈0.01） . More than 57.1% received drug sensi- tivity tests or had susceptibility results. The reason for consultations was to guide medication or drug selection. No less than 50.0% patients had used the third- generation cephalosporins and its enzymic preparations. The proportion of clinical phar- macists＇ advices being adopted increased year on year, up to 92.7% in 2007. Patients＇ conditions in no less than 42.9% cases took a favorable turn. CONCLUSION： Clinical pharmacists are helpful in providing clinicians with useful information such as the choice and application of antibacterials and points for attention in their application; however, they failed to carry out medication intervention before drug use, therefore their work style remain to be improved further.