糖肽类抗菌药物应用合理性调查分析

Investigation and analysis of rationality of using glycopeptide antibiotics

目的了解医院临床使用糖肽类抗菌药物的合理性,提高临床用药水平。方法采用回顾性调查方法,查阅2010年1-12月医院使用糖肽类抗菌药物的687例次住院患者病历,分析研究患者病情、药物联用、细菌培养及药敏试验等,评价临床用药合理性。结果 687例次中使用去甲万古霉素278例次、万古霉素283例次、替考拉宁126例次;其中109例次患者培养出细菌,根据药敏结果用药105例次占15.3%,经验用药占87.4%;用药合理197例次,占28.7%,用药基本合理269例次,占39.1%,用药不合理221例次,占32.2%;不合理用药中无适应证用药问题突出,有91例次,占不合理用药数的41.2%。结论应规范应用糖肽类抗菌药物,以避免出现难以控制的耐药局面。

OBJECTIVE To well understand the usage of glycopeptide antibiotics in hospital,evaluate the rationality of drug therapy,and improve the clinical medication level.METHODS Retrospective researching method was adopted for the study,a total of 687 patients who took the therapy of glycopeptide antibiotics from Jan.to Dec.2010 were recruited.For these patients,case reports,drug combination,bacterial culture and drug susceptibility tests were reviewed and statistically analyzed to evaluate the medication rationality.RESULTS Among the 687 cases,norvancomy was taken in 278 cases,vancomycin was taken in 283 cases,and teicoplanin was taken in 126 cases.Bacteria have been isolated from 109 cases,and 105 cases（15.3%） followed the results of the drug susceptibility test.Empirical treatment accounted for 87.4%.197 cases（28.7%） took the drugs reasonably.269 cases（39.1%） were basically rational and 221 cases（32.2%） were irrational.The problems of using drugs mismatching the indications were prominent in all the irrational use of drugs,including 91 cases,which accounted for 41.2% of all irrational drug uses.CONCLUSION We should use glycopeptide antibiotics rationally to avoid the uncontrollable drug resistance.