302例呼吸内科慢性阻塞性肺疾病住院患者抗菌药物用药调查

Surveillance of Antibiotics Prescription for Inpatients with COPD in A Hospital

目的了解呼吸内科慢性阻塞性肺疾病住院患者抗菌药物使用情况，促进抗菌药物的合理使用。方法回顾性调查某院呼吸内科2011—01—01，12—31出院的慢性阻塞性肺疾病住院患者病历。内容包括患者基本情况、诊断、过敏史、住院时长、用药情况、住院费用、药品费用和用药合理性评价等。结果共302例患者，主要诊断为慢性阻塞性肺病、慢性阻塞性肺病伴急性加重和慢性阻塞性肺病伴肺部感染等；氟喹诺酮类、β-内酰胺类／β-内酰胺酶抑制剂、头孢菌素类和大环内酯类等是最常用的抗菌药物；抗菌药物的使用在给药剂量和频次等方面存在某些不合理现象。结论慢性阻塞性肺疾病的抗菌药物应用基本符合指南的要求，但临床医生应能根据抗菌药物的PK／PD药代动力学特点更好地制订个体化的给药方案。

Objective To collect some information on antimicrobial prescription for patients of inpatients with chronic obstructive pulmonary disease （COPD） in a hospital, and to improve the rational application of antimicrobials. Methods： Records of inpatients discharged between Jan 1st and Dec 31st 2011 at the respiratory department who were recorded information about gender, age of patients, diagnosis, history of drug allergy, antimicrobial dosage, regimen, cost, etc, were retrospectively reviewed. The appropriateness of prescriptions was evaluated. Results： A total of 302 cases were assessed. Fluoroquinolones, beta-lactamase/enzyme inhibitor, cephalosporins and macrolides were the most used antibiotics. There were some inappropriate of drug dose, interval and solvents. Conclusion： Physicians can compliance with the guidelines to improve the management of COPD, but they should individualize the regimenin accordance with the PK/PD parameters of antibiotics.