临床药师干预模式下肾功能损伤患者万古霉素的用药效果

Administration efficacy of vancomycin in renal dysfunction patients under clinical pharmacists' intervention

目的探讨临床药师干预模式下肾功能损伤患者万古霉素的用药效果。方法回顾性分析74例肾功能损伤患者的临床资料,其中29例无临床药师干预下根据药物说明书及患者的肌酐清除率使用万古霉素(未干预组),45例在临床药师干预下根据血药浓度使用万古霉素(干预组),比较两组万古霉素给药剂量合理性、万古霉素用药疗程和用药总量、药物不良反应发生率、用药后肌酐升高幅度、治疗效果。结果干预组给药剂量不合理比例、每例患者用药总量、药物不良反应总发生率、急性肾功能损伤发生率、肌酐值升高幅度≥25%者比例均低于或少于未干预组(均P <0. 05)。两组的用药天数和治疗效果差异均无统计学意义(均P <0. 05)。结论对于肾功能损伤患者,临床药师干预模式可以减少万古霉素剂量使用不合理现象及不良反应的发生。

Objective To investigate the administration efficacy of vancomycin in the renal dysfunction patients under clinical pharmacists′intervention.Methods The clinical data of 74 patients with renal dysfunction were retrospectively analyzed.Twenty-nine patients(non intervention group),who didn′t receive clinical pharmacists′intervention,were administered vancomycin according to the instructions and their creatinine clearance rate,and the remaining 45 patients(intervention group)were administered vancomycin under clinical pharmacists′intervention according to the blood concentration.The related indices were compared between the two groups,including the rationality of vancomycin dosage after intervention,duration and total dosage of vancomycin administration,total incidence rate of adverse reactions,ascending range of creatinine after administration,and therapeutic efficacy.Results Compared to the non intervention group,the intervention group obtained lower proportion of cases with unreasonable administered dose,less total dosage of administration in each patient,lower total incidence rate of adverse reactions,lower incidence rate of acute renal dysfunction,and lower proportion of cases with creatinine ascending range≥25%(all P<0.05).There was no statistically significant difference in the duration of administration or therapeutic efficacy between the two groups(all P<0.05).Conclusion For the patients with renal dysfunction,the clinical pharmacists′intervention can improve the0x09unreasonable administered dose of vancomycin and reduce the incidence of adverse reactions.