从呼吸科患者住院前后抗菌药物的使用对比探讨高层次的合理用药

Explore Rational Use of Antibacterials on Higher Level by Comparative Analysis of Antibacterials Used for Respiratory Infection before and in Hospitalization

目的:比较呼吸科患者住院前后的抗菌药物使用情况,评价其使用的合理性。方法:依次查阅2012年6—8月呼吸道感染性疾病住院病历144份,记录其临床诊断,使用的抗菌药物的名称及用法与用量。对使用的抗菌药物种类及使用频次排序居前7位的抗菌药物进行统计、分析,对比住院前后选用抗菌药物情况,分析使用的合理性。结果:头霉素类(静脉给药)在临床使用率较高,头孢米诺在患者住院前使用率居首位,住院后使用率亦较高,与国内报告的用量排序相似。结论:头霉素类对呼吸道感染的常见病原菌药效较差,其药动学亦无优势,在治疗呼吸道感染时不宜作为一线药物选用或尽少使用,并在治疗规范中限制使用。

OBJECTIVE： To evaluate the use of antibiotics for patients in Pneumology Department before and after admission and evaluate the rationality of the use of antibiotics. METHODS： A total of 144 medical records of inpatients with respiratory tract infection diseases during June-August period of 2012 were reviewed in order, with clinical diagnoses, the names, dosage and administration of antibiotics administered before and after admission recorded. The categories of antibiotics and the top 7 antibiotics ranked by use frequency were analyzed statistically, and the choice of antibiotics and the rationality in the use of antibiotics before and after admission were analyzed contrastively. RESULTS： Cephamycins （intravenous administration） had high use rate clinically. The use rate of Cefminox dominated the first place before patients＇ admission and which was still high after admission and similar to the ranking of consumption amount of antibiotics as reported domestically. CONCLUSION： Cephamycins showed poor efficacy for common pathogens in respiratory tract infection and it had no superiority in pharmacokinetics, thus it is advisable not to use it as first line drugs, instead, we should try to reduce its use in the treatment of respiratory infection and limit its use in the treatment guidelines.