临床药师参与多重耐药菌感染患者的药学监护

Pharmaceutical Care for Patients with Multidrug-resistant Bacterial Infection by Clinical Pharmacists

目的:探讨临床药师对多重耐药菌感染患者开展抗菌会诊和药学监护的方法和效果,促进合理应用抗菌药物。方法:回顾性分析临床药师参与144例多重耐药或泛耐药菌感染患者治疗的情况,总结其科室分布、病原菌分布、治疗方案、治疗结果及药学监护情况。结果:重症加强护理病房是多重耐药菌感染发生率最高的科室,其次为神经内科、心血管、普外科;多重耐药菌以金黄色葡萄球菌、大肠埃希、鲍曼不动杆菌属居多,且出现了泛耐药菌株。临床药师用药方案的临床接受率为93.06%(134/144)。122例接受用药方案患者的治疗总有效率为82.79%(101/122)。结论:临床药师对多重耐药的患者进行会诊与药学监护,可有效减少抗菌药物滥用及医源性多重耐药菌的产生。

OBJECTIVE：To investigate the effects and methods for the treatment of patients with multidrug- resistant（MDR） bacterial infection by clinical pharmacists, so as to promote the rational application of antibiotics. METHODS： 144 cases of MDR or PDR bacterial infection consulted by clinical pharmacists were analyzed retrospectively. Ward distribution of MDR bacteria, distribution of pathogenic bacteriam, therapeutic regimen, therapeutic efficacy and pharmaceutical care were summarized respectively. RESULTS： ICU took the lead of the incidence of MDR bacterial infection, followed by neurology, angioearpy and general surgery. The multiple resistant bacteria were mainly staphylococcus aureus, acinetobacter baumanii and pseudomonas aeruginosa; pan drug resistant strains were appeared. The clinical acceptance rate of therapeutic regimen by clinical pharmacists was 93.06% （134/ 144）. The total effective rate of 122 patients with therapeutic regimen was 82. 79% （101/122）. CONCLUSIONS： The clinical pharmacists provide consultation and pharmaceutical care for patients with MDR bacterial infection can effectively reduce the abuse of antibiotics and the generation of iatrogenic multi-resistant bacteria.