387例社区获得性肺炎住院患者用药分析

Analysis on Drug Use of 387 Inpatients with Community-acquired Pneumonia

目的:了解佛山市顺德区第一人民医院附属陈村医院(以下简称"我院")社区获得性肺炎(community acquired pneumonia,CAP)住院患者用药情况,探讨其合理性。方法:统计我院电子病历系统2013年1月—2015年12月呼吸科主要诊断为CAP的出院患者387例,采用临床流行病学调查方法,对抗菌药物及呼吸道对症治疗用药的使用情况进行统计分析,根据2016年《社区获得性肺炎诊断和治疗指南》及相关药品说明书,同时结合药物利用指数(drug utilization index,DUI)和限定日费用(defined daily cost,DDC)对我院CAP患者用药合理性进行评价。结果:387例患者均使用了抗菌药物,抗菌药物使用率为100.00%;DDDs排序居前10位的抗菌药物中,使用率最高的为左氧氟沙星注射液,DUI>1.1的抗菌药物有4种,且静脉用药的DDC较口服高。呼吸道对症治疗药物中,使用率最高的为氨溴索注射液,且其DUI>1.1。结论:我院呼吸科CAP患者治疗用药与相关指南推荐用药基本相符,但仍存在静脉用抗菌药物的用法与用量不当、用药时间过长和氨溴索注射液使用剂量偏大等情况。

OBJECTIVE： To investigate the drug use of inpatients with community-acquired pneumonia（ CAP） in Chencun Hospital Affiliated to the First People＇s Hospital of Shunde（ hereinafter referred to as ＂our hospital＂）,and to probe into the rationality. METHODS： 387 discharged patients with CAP in electronic record system from Jan. 2013 to Dec. 2015 were collected,clinical epidemiological method was adopted,application of antibiotics and respiratory symptomatic treatment drugs were statistically analyzed. According to Guidelines for the Diagnosis and Management of Community-Acquired Pneumonia in 2016 and the related drug instructions,evaluation was conducted on the rationality of patients with CAP by drug utilization index（ DUI） and defined daily cost（ DDC）. RESULTS： Antibiotics were used in all patients,with the rate of 100. 00%; of the top 10 antibiotics ranked by DDDs,the top one was levofloxacin hydrochloride injections,there were 4 kinds of antibiotics with DUI〉1. 1,and the intravenous administration of DDC was higher than that of oral administration. Ambroxol injection was found to be most frequently used in respiratory symptomatic treatment drugs,and DUI 〉1. 1. CONCLUSIONS： The drug use in patients with CAP corresponds to the recommendation according to the guidelines in most cases. But there are still some unreasonable phenomenon such as improper intravenous antibiotics combination,improper dosage,prolonged course and overdose of ambroxol.