重症监护病房患者抗菌药物使用情况分析

Analysis of the use of antibacterial agents for patients in ICU

目的分析重症监护病房(ICU)患者抗菌药物的使用情况,促进抗菌药物在ICU的合理使用。方法回顾性分析2017年1~12月入住ICU患者的病例资料,利用Excel表格计算抗菌药物使用率、使用强度,特殊级抗菌药物使用率、使用强度及微生物标本送检率等。结果此期间共712例患者入住ICU,其中554例使用抗菌药物,使用率为77.81%,限制级、特殊级抗菌药物使用率为48.03%与12.78%;抗菌药物使用强度为168.40DDDs,临床使用抗菌药物以哌拉西林钠他唑巴坦和甲硝唑最多,使用强度分别为57.44DDDs和37.00DDDs;特殊使用级抗菌药物以美罗培南和万古霉素为主,使用强度分别为17.63DDDs和14.75DDDs;抗菌药物使用前进行微生物送检的患者有426例,送检率为76.90%。结论医院ICU抗菌药物的使用率偏高,使用强度较大,需加强有效、可行的措施以保护该类药物在治疗感染性疾病中的重要地位,同时减缓细菌耐药性的产生。

Objective To investigate the status of use of antibacterial agents for patients in the intensive care unit,so as to provide the way of using antibacterial agents rationally. Methods The clinical data of the patients in intensive care unit from Jan to Dee 2017 were retrospectively investigated. The usage rate of antibacterial agents, special use level, antibacterial agents, use density of them and inspection rate of microbiological specimen were calculated by Excel. Results Of totally 712 patients who were hospitalized in the ICU during the study period, and there were 554 patients used antibacterial agents, and the usage rate was 77.81%. The usage rate of antibaeterials for limit use was 48.03% and the usage rate of antibacterial agents for special use was 12.78%. Antibacterial agents use density was 168.40DDDs. The use of piperaeillin/tazobaetam and metronidazole were at the top two, and the antibacterial agents use density were 57.44DDDs and 37.00DDDs. In special use level of antibacterial agents, meropenem and vaneomyein hydroehloride made main part, the antibacterial agents use density were 17.63DDDs and 14.75DDDs. Among which, 426 patients made clinical microbiology test, and the inspection rate was 76.90%. Conclusion The usage rate of antibacterial agents and antibacterial agents use density are high in ICU, so should make more effective and feasible measures, so as to ensure the important position of this type of drugs in treatment of infectious disease and slow down the incidence of bacterial resistance.