肝硬化住院患者的抗菌药物应用分析

Analysis of antibacterial agent use in liver cirrhosis patients

目的分析肝硬化住院患者的抗菌药物使用情况,促进肝硬化患者抗菌药物应用的合理化。方法统计分析2016年我院肝硬化住院患者的住院信息及抗感染治疗相关数据,结合用药频度(DDDs)、药物利用指数(DUI)等指标,对用药合理性进行分析。结果 596例肝硬化住院患者中,165例发生感染,感染率为27. 68%,以呼吸道感染为主,其次为发热待查、肠道和腹腔感染。共计325例患者使用抗菌药物,使用率为54. 5%,其中预防用药49. 2%,治疗用药50. 8%,使用抗菌药物患者微生物送检率为33. 94%。抗菌药物使用以静脉用药为主,单药治疗占84. 6%,平均用药疗程(7. 50±4. 59) d,最长30 d。使用频率最高的药物为头孢西丁,其次是头孢替安和头孢甲肟;在使用频率较高的10种抗菌药物中,8种药物的DUI值≤1。结论肝硬化患者抗菌药物使用存在部分患者药物选择不当、个别药物剂量偏大等现象,且存在病原学送检率低、用药疗程不规范等不合理现象。

Objective To analyze the use of antibiotics in hospitalized patients with liver cirrhosis, and to pro- mote the rationalization of antimicrobial agents use in patients with liver cirrhosis. Methods The hospitalization infor- mation and anti-infection treatment data of hospitalized patients with liver cirrhosis in 2016 were analyzed, and the ra- tionality of drug use was analyzed in combination with DDDs,DUI and other indexes. Results Among the 596 cases of liver cirrhosis, 165 cases were infected, the infection rate being 27. 68% , which was mainly respiratory tract infec- tion, followed by fever needing examination,intestinal and abdominal infection. A total of 325 patients were treated with antibiotics, the rate of use being 54.5% ,of which 49. 2% used preventive drugs,50. 8% used treatment drugs, and the rate of microbiological delivery was 33.94%. The main usage of antibiotics was intravenous medication; single drug treatment accounted for 84. 6% ;the average course of treatment was （7. 50 ±4. 59） d,and the longest was 30 d. The most frequently used drug was cefoxitin, followed by ceftazine and cefimoxime;the DUI value of 8 of the 10 antibiotics with higher frequency was less than 1. Conclusion The use of antibiotics in some patients with liver cirrhosis is not appropriate and the dosage of individual drugs is large, and there are some unreasonable phenomena such as low rate of pathogeny and nonstandard course of treatment.