我院腹腔感染患者抗菌药应用分析

Analysis of the Utilization of Antibacterial Agents in Abdominal Cavity Infection Patients

目的：调查分析我院腹腔感染患者的抗菌药使用情况，指导临床合理应用抗菌药物治疗腹腔感染。方法：抽查我院2014年1~7月份腹腔感染出院患者病历共220份，对抗菌药使用情况进行统计分析。结果：220份病历均使用了抗菌药，共涉及10类24种：单一用药92例（占41.8%），二联用药126例（占57.3%），三联用药2例（占0.91%）。应用的抗菌药物以头孢菌素类（含加酶抑制剂复合制剂）的使用率最高；其次为青霉素类（含加酶抑制剂复合制剂）；排在第三位的是硝基咪唑类。以两联用药为主，联用类别主要为β-内酰胺类联合硝基咪唑类及β-内酰胺类联合喹诺酮类。平均用药时间5.57 d。进行细菌培养及药敏试验的病例有47例，检出的致病菌主要是革兰阴性菌，有大肠埃希菌、铜绿假单胞菌及肺炎克雷伯菌。结论：我院腹腔感染患者抗菌药应用基本合理，但也存在联合用药不合理、疗程超长等情况，应进一步加强管理。

Objective： To analyze the utilization of antibacterial agents in abdominal infection cases, and to provide guidance for rational use of antibacterial agents in the clinic. Methods： A total of 220 abdominal infection cases were collected in our hospital from January to July of 2014, and the data of antimicrobial agents use were statistically analyzed. Results： There were a total of 24 drugs of 10 categories used in 220 cases, with 92 cases using single drug （57.3%）, 126 cases using two drugs （57.3%）, and only two cases using three drugs （0.91%）. The top three varieties of antibacterials included cephalosporins （with enzyme inhibitor compound preparations）, penicillins （with enzyme inhibitor compound preparations） and nitroimidazoles. Two drugs combination was the main application in the antimicrobial drugs, the main combination types were β-lactam＋quinolones and β-lactam＋ nitroimidazoles. The average medication time was 5.57 d. Bacterial cultivation and drug sensitivity test were conducted in 47 cases, among which most of them were Gram negative bacteria infections, such as Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae. Conclusion： The utilization of antibacterial agents in abdominal infection cases in our hospital was essentially rational. However, there were cases of irrational use and long time use of antibacterials, which needs strengthened management.