2011—2016年鄂州市中心医院抗菌药不良反应分析

Analysis on adverse drug reactions induced by antibacterial drugs in Ezhou Central Hopstial from 2011 to 2016

目的分析鄂州市中心医院抗菌药致不良反应(ADR)的发生规律与用药频度(DDDs)相关性,为临床安全、合理用药提供参考。方法将该院2011年9月—2016年8月收到的抗菌药致ADR报告录入Microsoft Excel 2000软件,对抗菌药的类别、药品名称、临床表现、DDDs及ADR构成比(B)与DDDs排序比(A)的比值(B/A)进行统计分析。结果共发生151例ADR,涉及10类抗菌药,前3位的分别为氟喹诺酮类、头孢菌素类和青霉素类,用药频度前3位的分别为头孢菌素类、氟喹诺酮类和大环内酯类,头孢菌素类、大环内酯类和抗真菌药的B/A值大于1。ADR构成比前4位的分别为左氧氟沙星、莫西沙星、头孢美唑和头孢替安,用药频度前4位的依次为左氧氟沙星、头孢地嗪钠、阿奇霉素和头孢美唑,头孢地嗪钠、甲硝唑、阿奇霉素的B/A值大于1。左氧氟沙星和莫西沙星发生严重ADR的几率较高,左氧氟沙星和头孢替安发生新的ADR几率较高。结论抗菌药致ADR发生率与DDDs基本相符,应警惕ADR发生率较高的药品,如头孢地嗪钠、甲硝唑、阿奇霉素等。

Obiective To analyze the characteristics of antibacterial drugs caused adverse drug reactions （ADR） and correlation with DDDs in Ezhou Central Hospital,and provide reference for safe and rational use of antibacterial drug in clinic.Methods ADR reports of antibacterial drugs in Ezhou Central Hospital from September 2011 to August 2016 were entered into Microsoft Excel 2000 software,Statistical analysis was performed on the categories of antimicrobials,drug names,clinical manifestations,and DDDs,composition ratio of ADR and ratio ofB/A.Results Involved in 151 ADR cases and 10 kinds of antibacterial drugs,the top 3 antibacterial drugs respectively were Fluoroquinolones,Cephalosporins,and Penicillins,the top 3 DDDs respectively were Cephalosporins,Fluoroquinolones,and Macrolides,and the B/A values of Cephalosporins,Macrolides,and Antifungal agents were over 1.The top 4 ADR composition ratios respectively were Levofloxacin,Moxifloxacin,Cefmetazole,and Cefotiam,and the top 4 DDDs respectively were Levofloxacin,Cefodizime sodium,Azithromycin,and Cefmetazole,and the B/A ratios of Cefodizime sodium,Metronidazole,and Azithromycin were over than 1.Levofloxacin and moxifloxacin had a higher risk of severe ADR,and Levofloxacin and Cefotiadine had a higher risk of new ADR.Conclusion The ADR rate of antibacterial drugs is basic consistent with its DDDs.Clinical should pay more attention to the individual drugs with higher rates of ADR,such as Cefodizime sodium,metronidazole,and azithromycin etc.