我院呼吸内科抗菌药物应用分析及药学服务模式探讨

Exploration of rational use of antibiotics in the department of respiratory medicine and pharmacy services mode in our hospital

目的 分析我院呼吸内科抗菌药物的应用情况,并探讨临床药师参与临床药物治疗的服务模式.方法 回顾性分析我院自2010年6月~2013年8月收治的呼吸内科患者临床资料.比较分析临床药师采用的3种不同的服务模式（分别为传统药学服务模式、间接药学服务模式干预以及直接药学服务模式干预）对呼吸内科患者抗菌药物使用强度、联合抗菌药物使用率、不良反应报告率、抗菌药物分级以及特殊使用级抗菌药物使用率、微生物标本送检率情况的影响.结果 （1）间接干预组和直接干预组患者在抗菌药物使用强度、联合抗菌药物使用情况、微生物标本送检率、不良反应报告率以及抗菌药物分级使用、特殊使用级抗菌药物使用情况等方面表现均显著优于传统组（P〈0.05）,其中传统组的不良反应报告率为2.60%,间接干预组为9.38%,直接干预组为7.99%;（2）两组患者在微生物标本送检率、不良反应报告率、特殊使用级抗菌药物使用率、联合抗菌药物使用率以及抗菌药物分级使用情况方面比较差异无统计学意义（P〉0.05）,而在抗菌药物使用强度方面,直接干预组患者表现显著优于间接干预组（P〈0.05）.结论 临床药师所采用的药学服务模式能够显著提高呼吸内科患者抗菌药物的使用效率,相对间接干预而言,直接干预的效果更好,值得临床大力推广使用.

Objective To investigate pharmacy services mode in the department of respiratory medicine in our hospital. Methods The clinical data of patients with respiratory medicine were retrospective analyzed from June 2010 to August 2013. The clinical pharmacists used three different service modes （traditional traditional pharmaceuti-cal care mode, indirect pharmaceutical care mode interference and pharmaceutical care mode directly intervention） to analyze the influence on combined antimicrobial usage, adverse reaction report class and special use of antimicrobial agents, antibacterial drug usage, and microbial specimens detection rate. Results （ 1 ） The indirect intervention group and the intervention group had better antimicrobial use intensity, combined use of antimicrobial agents, micro-bial specimen sampling rate, the rate of adverse reaction reports and antimicrobial drug class use, and special use performance aspects such as the use of antimicrobial agents than the traditional group did （ P〈0. 05 ） . The adverse reaction report rate was 2. 60% in the traditional group, 9. 38% in the indirect intervention group, and 7. 99% in the direct intervention group 7. 99%. （2） There was no significant difference in microbial inspection rate, adverse reac-tions report rate, special use level of antimicrobial drug, combined antimicrobial usage and usage of drug classifica-tion between the intervention group and the indirect intervention group （P〉0. 05）, but the intensity of antibacterial drug use was better in the intervention group than in the indirect intervention group （P〈0. 05）. Conclusion Clini-cal pharmacists in pharmaceutical care mode can significantly improve the efficiency of the use of antimicrobial agents for patients with respiratory medicine, and the direct intervention effect is better, which is worthy of widely clinical practice.