专项医嘱点评对我院万古霉素类药物合理应用的影响

Effect of special prescription comment on rational use of vancomycins in our hospital

目的：探讨专项医嘱点评对我院万古霉素类药物临床合理应用的影响。方法：记录我院2013年1～6月和2014年1～6月使用了万古霉素类药物患者的全部信息，其中前者纳入专项点评前组，后者纳入专项点评后组。对2组患者的用药情况、细菌送检率、不良反应发生率、治疗效果等进行对比分析。结果：与专项点评前组比较，专项医嘱点评后组患者实验室指标检查频次明显增加，患者细菌送检率由46．74％增长至86．87％（P〈0．01）；不适宜用药由120人次降至29人次；治疗有效率由54．26％增至69．70％（P〈0．05），不良反应发生率由6．52％降至1．01％（P〈0．05）。结论：专项医嘱点评显著促进了我院万古霉素类药物临床应用的合理性，但该项管理工作仍需制度化、长期化。

Objective ： To investigate the effect of special prescription comment on rational use of vancomyeins in our hospital. Methods： The information of all inpatients receiving treatment of vancomycins during Jan. - Jun. 2013 （pre-comment＇ group） and Jan.-Jun. 2014 （post-comment＇ group） was collected. The situation of medication, and bacterial examination rate, adverse reaction rate, efficacy and so on were compared, respectively. Resuits： Compared with pre-comment＇ group, the ratio of examination indexes for patients were increased obviously. The bacterial examination rate was increased from 46.74% to 86.87% （P 〈 0.01 ）. The irrational drug uses were decreased from 120 to 29. The effective rate of treatment was increased from 54.26% to 69.70% （P 〈 0.05） , while the rate of adverse drug reactions was decreased from 6.52% to 1.01% （P 〈 0.05）. Conclusion： The special prescription comment can significantly improve the rational use of vancomycins in our hospital, but the management work still needs to be institutionalized and long-term oriented.