信息化感染监控系统对合理使用抗菌药物的指导作用

Guiding Significance of Informatization Infection Control System for Rational Use of Antibiotics

目的探讨在信息化感染监控系统指导下,通过抗生素的用药频度和药物利用指数比较信息化前后抗生素的合理使用情况。方法将2014年3月至2015年2月急诊重症监护病房应用感染监控系统后收治的672例感染患者作为观察组;2013年3月至2014年2月应用感染监控系统前收治的665例感染患者作为对照组。观察使用信息化感染监控系统前后,抗革兰阴性杆菌药物用药频度、药物利用指数的变化情况并进行比较。结果应用感染监控系统指导抗生素治疗后,观察组中抗生素的用药频度(亚胺培南45.750、头孢哌酮舒巴坦钠89.358、莫西沙星39.283、头孢曲松钠79.629、哌拉西林钠他唑巴坦75.084)较对照组(亚胺培南53.450、头孢哌酮舒巴坦钠99.867、莫西沙星46.592、头孢曲松钠86.540、哌拉西林钠他唑巴坦81.892)明显下降;观察组中抗生素的药物利用指数(亚胺培南0.933、头孢哌酮舒巴坦钠0.885、莫西沙星0.758、头孢曲松钠0.982、哌拉西林钠他唑巴坦0.909)较对照组(亚胺培南1.076、头孢哌酮舒巴坦钠1.005、莫西沙星0.887、头孢曲松钠1.096、哌拉西林钠他唑巴坦1.105)也有明显改善。结论通过应用信息化感染监控系统对EICU中的革兰阴性杆菌感染患者的信息进行实时监控、分类记录、数据整理,使亚胺培南、头孢哌酮舒巴坦钠、莫西沙星、头孢曲松钠、哌拉西林钠他唑巴坦的用药频度、药物利用指数较未使用系统时明显下降,抗生素使用更加合理化。

Objective To discuss the reasonable usage of antibiotics before and after the information monitoring system was used for guidance of infection through the antibiotic drug use frequency and drug utilization index comparison. Methods 672 cases who were hospitalized after the application sense of information control system in our emergency intensive care units （EICU） from March 2014 to February 2014 were included into observed group. 665 cases who were hospitalized before the application sense of information control system in EICU from March 2013 to February 2014 were in- eluded into control group. We observed gram-negative bacillus drug resistance changes in frequency, drug utilization index before and after infection monitoring system using informatization. Results Antibiotic drug use frequency in the observation group after infection monitoring system guidance imipenem （ eefoper- azone sodium shu ba, moxifloxaein, eeftriaxone sodium and piperaeillin sodium he azole temple） de- creased obviously （ t = - 2. 153, P 〈 0.05 ; t = - 2. 254, P 〈 0.05 ; t = - 2. 430, P 〈 0.05 ; t = - 2. 296, P 〈 0.05 ; t - - 2. 268, P 〈 0.05 ）, the drug utilization index compared with the control group have obvious- lyimproved（t= -2.650,P〈0.05;t = -2.288,P〈0.05;t = -3.532,P〈0.05;t = -2.422,P〈 0.05 ; t = - 2. 290,P 〈 0. 05）. Conclusion Infection monitoring system through the application of infor- matization in patients with gram-negative bacilli infection in EICU information real-time monitoring, classification, reeordsand data sorting make drug use frequency, drug utilization index declined obviously, antibiotic use is more reasonable.