某市抗生素类药物不良反应报告综合分析

Comprehensive analysis of adverse drug reaction reports of antibiotics in a city

目的分析2014年1月~2016年12月某市所有医院抗生素类药物不良反应(ADR)报告,比较分析其数据特点,以减少抗生素不良反应的发生,促进临床对抗生素的合理使用。方法回顾性分析2014年1月~2016年12月某市的5630例抗生素类ADR报告,利用计算机分析系统,分析抗生素药品不同性别、年龄、给药途径的ADR发生情况;分析抗生素药品新发生ADR及全部ADR的严重程度;分析抗生素药品新发生严重ADR累及系统器官和临床表现;分析抗生素药品ADR经对症处理后的转归情况;分析不同抗生素药品ADR的发生情况。结果5630例抗生素类药物的ADR报告中,男2617例(46.48%),女3004例(53.36%),性别不详9例(0.16%)。抗生素类药物引起的ADR发生年龄大多在1~10和>40~70岁;静脉滴注的给药途发生ADR最多;新发生的ADR为1047例(18.60%),2014和2015年的新发ADR例数高于2016年;从ADR严重程度分类分析,所有报告共计发生严重ADR为171例(3.04%),2015、2016年的严重ADR略微高于2014年;新发严重ADR临床表现中皮肤及其附件损害最严重,其次为全身性损害。全部ADR报告中,共3165例(56.42%)痊愈,其中2014、2015年基本持平,2016年略有降低;共2312例(41.21%)好转,各年度例数基本持平;共有20例出现了后遗症(0.36%)。全部ADR报告中,发生ADR最多的抗生素为左氧氟沙星,其次为阿奇霉素和头孢呋辛。结论临床治疗中应采用合适的给药途径、给药剂量,同时须密切关注用药过程,时刻注意新的ADR发生,对于老人和儿童用药须做好更细致的临床监护工作,保证用药安全。

Objective To analysis the adverse drug reaction(ADR)reports of all hospitals in a city from January 2014 to December 2016,and compare the characteristics of the data to reduce the incidence of adverse reactions and promote the rational use of antibiotics in the clinic.Methods A retrospective analysis of 5630 ADR reports of antibiotics in a city from January 2014 to December 2016 was carried out.The ADR incidence of antibiotics in different gender,ages and routes of administration were analyzed by computer analysis system.The severity of new ADR and all ADRs of antibiotics were analyzed.New serious ADR involving systemic organs and clinical manifestations of antibiotics were analyzed.The outcome of antibiotic ADR after symptomatic treatment were analyzed.The occurrence of ADR in different antibiotics were analyzed.Results A total of 5630 antibiotics ADR reports,2617 were male(46.48%),3004 were female(53.36%),and 9 were unknown(0.16%).The age of ADR caused by antibiotics was mostly between 1-10 and>40-70 years.The most frequent ADR occured during the administration of intravenous drip.The number of new ADR was 1047(18.60%),and the number of new ADRs in 2014 and 2015 was higher than that in 2016.According to the classification analysis of the severity of ADR,171 cases(3.04%)of severe ADR were reported in all reports,the severe ADRs in 2015 and 2016 were slightly higher than in 2014.In the clinical manifestations of new severe ADR,the skin and its accessories were the most severe,followed by systemic damage.In all ADR reports,a total of 3165 cases(56.42%)were cured.Among them,2014 and 2015 were basically the same and slightly decreased in 2016.A total of 2312 cases (41.21%) improved and the number of cases was basically the same in each year. A total of 20 cases had sequelae (0.36%). Of all the ADR reports, the Levofloxacin was the most frequently occurring ntibiotic, followed by Azithromycin and Cefuroxime. Conclusion Appropriate routes of administration and doses should be used in clinical treatment. At the same time, the medication process must be closely monitored, and the occurrence of new ADRs must be paid attention to. The elderly and children should be given more careful clinical monitoring to ensure the safety of medication.