某大型三甲医院万古霉素使用情况回顾性分析

Retrospective analysis of vancomycin usage in a tertiary hospital

目的对本院万古霉素使用情况进行合理性评价,为临床合理应用万古霉素提供参考。方法采用回顾性分析方法,收集本院2014年1月-2015年12月住院患者使用万古霉素病例328份,根据《抗菌药物临床应用指导原则》2015年版、《万古霉素临床应用中国专家共识》对病例进行点评分析。结果共收集328份病例。其中手术预防用药的患者有155例,手术预防有效率100%;治疗用药的患者有173例,临床治疗有效率达到84.39%;但是治疗前标本送检率只有65.32%,不合理使用万古霉素82例(25%)。结论本院万古霉素使用上存在不合理情况,特别是对适应证的把握还有待提高。应采取全面的干预措施,促进万古霉素合理使用,从而延缓耐药菌株的产生。

Objective To evaluate the rational use of vancomycin in our hospital to optimize vancomycin usage. Methods According to the ＂Principles of Clinical Use of Antibiotics＂ and the ＂China Expert Consensus on Clinical Application of Vancomycin＂, we retrospectively evaluated 328 patients who received intravenous vancomycin from January 2014 to December 2015. Results Totally 328 patients were evaluated. Totally 173 patients used vancomycin for treatment, with the effective rate 84.39%. Totally 155 patients used vancomycin for prophylaxis, with the effective rate of prophylaxis was 100%. However, the microbiology laboratory specimen submission rate was only 65.32%, and 82 cases（25%） were considered irrational. Conclusion There is still unreasonable use of vancomycin in our hospital. The knowledge of indication and treatment duration should be improved. Comprehensive intervention should be implemented to optimize vancomycin usage and reduce growing antibiotic resistance.