经验性抗菌药物治疗医院感染患者的研究

Study on empirical use of antibiotics for treatment of nosocomial infections

目的了解医院感染患者经验性抗菌药物选择的准确性和药敏试验后抗菌药物调整情况,以指导临床用药。方法回顾性分析2010年1月-2014年12月医院感染100例患者的临床资料,分析经验性抗菌药物选择的准确性和药敏试验后抗菌药物调整情况,采用SPSS 17.0软件进行统计分析。结果 100例医院感染患者共检出100株病原菌,以革兰阴性菌为主,共87株占87.0%;感染部位的病原菌分布以下呼吸道为主,共48例占48.0%;100例患者初始治疗均经验性应用抗菌药物,与药敏试验后调整用药的符合率为48.0%,不同感染部位的抗菌药物经验性与药敏试验后调整用药的符合率差异较大;抗菌药物经验性与药敏试验后调整用药符合的患者治疗有效率为95.8%,显著高于不符合患者的治疗有效率71.2%,差异有统计学意义(P<0.05)。结论初始抗菌药物的准确使用对医院感染患者的预后具有重要意义,应根据药敏试验结果及时调整抗菌药物的使用。

OBJECTIVE To understand the accuracy of empirical use of antibiotics for the treatment of patients with nosocomial infections and adjust the drug administration based on the drug susceptibility testing so as to guide the clinical medication.METHODS From Jan 2010 to Dec 2014,the clinical data of 100 patients with nosocomial infections were retrospectively analyzed,then the accuracy of the empirical use of antibiotics and the adjustment of drug administration after drug susceptibility testing were observed,and the statistical analysis was performed with the use of SPSS17.0software.RESULTS A total of 100 strains of pathogens have been isolated from the 100 patients with nosocomial infections,of which 87.0%（87strains）were the gram-negative bacteria.The patients with lower respiratory tract infections accounted for 48.0%（48cases）.All the 100 patients empirically used antibiotics for the initial treatment,and the accordance rate with adjusted medication based on the drug susceptibility testing was48.0%;the empirical use of antibiotics for treatment of different sites of infections and the adjusted medication based on the drug susceptibility testing varied significantly in the accordance rate.The effective rate of treatment of the patients for whom the empirical use of antibiotics was in accordance with the adjusted medication based on the drug susceptibility testing was 95.8%,significantly higher than 71.2% of the patients for whom the empirical use of antibiotics was not in accordance with the adjusted medication based on the drug susceptibility testing（P〈0.05）.CONCLUSIONThe accurate initial use of antibiotics has great significance in the prognosis of the patients with nosocomial infections.It is necessary to adjust the drug administration based on the results of drug susceptibility testing.