某院万古霉素/去甲万古霉素评价标准的建立及应用

Establishment and Application of the Evaluation Standard of Vancomycin/Norvancomycin in the Hospital

目的建立某院万古霉素/去甲万古霉素药物利用评价标准,为临床合理用药提供参考依据。方法收集医院2015年上半年使用万古霉素/去甲万古霉素的所有出院病历59份,参照国内的药物利用评价标准,结合医院实际情况设计患者使用万古霉素/去万古霉素调查表,评估该药使用情况。结果在医院万古霉素/去甲万古霉素使用过程中,未发生药物配伍禁忌及药品不良反应,在医院管理指标、用药指征、用法用量、溶剂选择等方面存在不合理现象,管理指标符合率为77.97%,用药指征符合率为71.19%,用法、用量及疗程符合率为83.05%,溶剂选用和滴注时间符合率为89.83%,第1次使用前72 h以内细菌培养符合率为61.02%,第1次使用前应检查血肌酐,血肌酐在正常范围内,最少1周进行1次血肌酐测试符合率为64.41%。结论开展万古霉素/去甲万古霉素评价有利于药物的合理应用及提高临床药师的地位。

Objective To establish and apply the evaluation standard for the use of vancomycin/norvancomycin in the hospital to provide reference for clinical rational use of drugs. Methods 59 pieces of discharged medical orders using vancomycin/norvancomycin in the first half of 2015 were collected, and the usage was evaluted by the questionnaire that was designed with referrence to the domestic drug use standard as well as the actual situation of the hospital. Results In the course of using vancomycin/norvancomycin in the hospital, there were no drug compatibility and adverse drug reactions. There were some irrational phenomena in the hospital management index, medication indication, usage and dosage, and solvent selection etc.,with the accordance rate of the management index 77.97%, medication indication 71.19%, usage, dosage and treatment course 83.05%, solvent selection and the infusion time 89.83%, and bacte- rial culture 72 h before the first usage 61.02%. The blood creatinine should be checked before the first usage to make sure it was in the normal range; the accordance rate of checking the blood creatinine at least once in a week was 64.41%. Conclusion Carrying out the evaluation of rational use of vancomycin/norvancomycin is good for the rational drug use and the improvement of the status of clinical pharmacist.