149例呼吸科抗真菌药应用调查分析

Use of Antifungal Drugs in Pneumology Department:Analysis of 149 Cases

目的:调查呼吸科患者抗真菌药的应用情况并初步评价用药的合理性。方法:采用回顾性调查方法,查阅患者的原始病历,根据合理用药指标,采用"限定日剂量"、"用药频度"、"药物利用指数"等分析评价用药情况。结果:使用抗真菌药的149例患者中,老年、使用广谱抗菌药物、合并糖尿病或进行呼吸道侵入操作的患者较多地使用了抗真菌药;白色念珠菌感染46例(92%);预防性用药103例(68%);使用的抗真菌药均为唑类抗真菌药的2个品种。氟康唑和伊曲康唑是常用的抗真菌药品种,DUI值分别为1.43和1.5;抗真菌药使用前后6例出现一过性的肝损害,1例肾损害。结论:呼吸科抗真菌药应用基本合理,但存在用药剂量偏大的情况,需进一步规范抗真菌药的应用,提高用药的安全性与合理性。

OBJECTIVE：To investigate the use of antifungal agents in patients from department of pneumology and evaluate the rationality of the drug use.METHODS：The medical records of patients in peumological department were retrospective studied for evaluation of drug use based on the indexes for rational drug use by using defined daily dose,DDDs and drug utilization index etc.RESULTS：Of the total 149 patients who were treated with anti-fungal drugs,anti-fungal drugs were predominantly used in senile patients,patients receiving broad-spectrum antimicrobial agents and those associated with diabetes mellitus or those undergoing invasive operations.46 cases（92%） were infected with candida albicans infection;103 cases（68%） used anti-fungal drugs prophylactically.All of the antifungal agents used belonged to the two subtypes of azoles antifungal agents.Fluconazole and itraconazole triazole were the commonly used antifungal agents,and their DUI values were 1.43 and 1.5,respectively.Hepatic lesion appeared in 6 cases and renal lesion in 1 case after use of antifungal agents.CONCLUSION：The use ofantifungal agents in patients from pneumology department is basically rational.However,the dose of which is still on the high side,thus it is necessary to tighten control on the standard use of antifungal agents to improve the safety and rationality of drug use.