循证药学在外科ICU抗真菌治疗中的临床应用

Application of Evidence-based Pharmacy in Utilization of Antifungal Therapy in General Surgery ICU

目的:查找循证药学证据,解决临床用药问题,比较抗真菌药的有效性、安全性以及个体化用药。方法:通过对1例ICU肾移植术患者抗真菌治疗,检索数据库,查找相关的系统评价、随机对照试验等,并对所获得的证据进行质量评价。结果与结论:检索到系统评价3篇,安全性比较的随机对照试验1篇。各种抗真菌药的抗菌谱略有不同,各有特点,但是总体的病死率和反应率没有显著性差异,两性霉素B的不良反应率最高,棘白菌素类的不良反应率最低。临床药师根据患者特殊性和病情特点选择了合适的药物,疗效显著。

OBJECTIVE：To search evidence of evidence-based pharmacy to resolve clinical use of drugs,and to compare the effectiveness and safety of antifungal agents and individual drug therapy regimen. METHODS：Relevant databases were retrieved to find related systematic review and randomized control trials（RCTs）,and the quality of data was evaluated. RESULTS CONCLU- SION：3 systematic reviews and 1 RCTs about security were obtained. There were a lot of differences about antimicrobial spectrum. There was no significant difference in total mortality and response rate. The incidence rate of ADR induced by Amphotericin B was the highest while echinocandins was the lowest. Clinical pharmacists chose antifungal agents according to specificity of patients and their condition.