某院碳青霉烯类抗菌药物的使用与监管

Use and supervision of carbapenems in a hospital

目的了解某院碳青霉烯类抗菌药物临床使用情况,分析管理存在的问题,促进碳青霉烯类抗菌药物的合理使用。方法对2018年1月1日至2018年10月31日碳青霉烯类抗菌药物的消耗情况进行统计,并从医院信息系统对该时间段内使用碳青霉烯类抗菌药物的病例进行回顾性分析。结果美罗培南(国产)的消耗量、金额、DDDs高于美罗培南(美平)和比阿培南。应用碳青霉烯类抗菌药物排名前十的科室有肾病内科、呼吸内科、重症医学科、血液内科、神经外科、心血管内科、肝胆外科、老年病科、小儿外科、小儿内科。排名前十位的科室碳青霉烯使用患者达541例,占所有使用该类药物患者的83.36%;其中药学会诊170例,占31.42%。药学会诊占使用例数的比例排名前三位的是神经外科、肝胆外科、老年病科。结论我院碳青霉烯类抗菌药物使用基本合理,但仍存在不合理现象,需进一步严格管理。临床药师应加大干预力度,从而有效遏制细菌耐药。

Objective To understand the clinical use of carbapenems in a hospital, analyze the problems in management, and promote the rational use of carbapenems. Methods The consumption of carbapenems from January 1, 2018 to October 31, 2018 was analyzed, and a retrospective analysis was made on the cases of carbapenems used in this period from the hospital information system. Results The consumption, amount of money and DDDs of meropenem (made in China) were higher than those of meropenem (Meiping) and biapenem. The top ten departments using carbapenems are nephrology, respiratory medicine, critical medicine, hematology, neurosurgery, cardiovascular medicine, hepatobiliary surgery, geriatrics, pediatric surgery and pediatric medicine. In the top ten departments, there were 541 cases using carbapenems, accounting for 83.36% of all patients using carbapenems, and of which 170 cases recived pharmaceutical consultation, accounting for 31.42%. The proportion of pharmaceutical consultation in use cases accounted for the top three were neurosurgery, hepatobiliary surgery and geriatrics. Conclusion The use of carbapenems in our hospital is basically reasonable, but there are still unreasonable phenomena, which need further strict management. Clinical pharmacists should strengthen intervention to effectively curb bacterial resistance.