临床药师对肿瘤患者抗菌药物干预效果分析

Analysis of intervention effects of antibiotics in tumor patients by pharmacists

目的:动态分析某三甲医院肿瘤患者抗菌药物的使用情况,考察临床药师用药干预对合理使用抗菌药物的促进效果。方法:利用回顾性调查方法对某医院肿瘤患者抗菌药物使用情况进行动态分析。每月每个病区随机抽取使用抗菌药物的患者进行审核。应用PDCA循环管理对一病区抗菌药物使用的合理性进行干预。比较一病区和二病区抗菌药物的动态变化。结果:肿瘤内科一病区和二病区抗菌药物使用率分别为(6.3±1.5)%和(12.5±2.8)%(P<0.01)、抗菌药物费用占药费总额百分率分别为(1.6±1.2)%和(2.8±1.0)%(P<0.05);2个病区抗菌药物合理率分别为82.3%和66.6%(P<0.05)。不合理用药主要表现在用法用量不合理、无用药指征、用药级别高、特殊级抗菌药物无感染专科会诊单、越级使用抗菌药物。结论:老年肿瘤患者感染发病率较高,PDCA干预病区的抗菌药物使用率、使用强度、抗菌药物费用低于非干预病区。临床药师用药干预实践能够促进抗菌药物的合理使用。

OBJECTIVE To dynamically analyze use of antibiotics in a grade A class three teaching hospital for influences of PDCA cycle management model on promoting rational use of antimicrobial agents. METHODS Retrospective survey was adopted for dynamic analysis of antibiotics for tumor patients. Patients under antibiotics treatment were randomly screened every month in each oncology unit. Management of PDCA had intervened irrational treatment for tumor patients under antibiotics treatment in the first oncology unit. Indicators of rational use of antibiotics had been compared in the first and second units for one year. RESULTS Percentages of antibiotics use was （6. 3 ± 1.5） % and （12. 5 ± 2. 8） % in the first and second units （P〈 0. 01）. Expense of antibiotics accounted for （1.6 ± 1.2） % and （2. 8 ± 1.0） % in total expense of medicine （P〈0. 05）, and rational rates were 82. 3% and 66. 6% （P〈0. 05） in the first and second units, respectively. Phenomena of irrational drug use included errors of usage and dosage, beyond indications, antibiotics of high grades, special class of antibiotics without consulta- tion order, and antibiotics ordered by doctor without license. CONCLUSION Elderly patients with tumors had higher inci- dences of infection. Use rate, intensity and expense of antibiotics decrease in oncology unit intervened by PDCA than the unit without intervention. Intervention by clinical pharmacists can promote rational use of antibiotics.