110例新型冠状病毒肺炎出院患者抗菌药物使用情况分析

Analysis of Use of Antibacterial Drugs in 110 Discharged Patients with COVID-19

目的了解我院110例新型冠状病毒肺炎(COVID-19)出院患者抗菌药物使用情况,探讨COVID-19患者抗菌药物的合理应用。方法收集2020年1月24日至2020年2月19日出院的110例COVID-19患者的病例资料,对其抗菌药物使用情况、入院症状、胸部CT检查、临床分型、病原学检查、感染指标等信息进行回顾性分析。结果110例出院患者抗菌药物使用率100%,特殊级抗菌药物使用率54.5%,联合抗菌药物治疗的患者比例为78.2%。入院血常规白细胞数值多数正常或偏低、中性粒细胞数值大部分处于正常范围、淋巴细胞数值主要表现为不同程度的降低。入院首次测得降钙素原(PCT)正常的有96例(87.3%),在整个治疗过程中PCT均正常的有94例(85.5%)。结论COVID-19暴发早期,我院广谱抗菌药物联用和特殊级抗菌药物使用比例较高是这个阶段突出的问题。随着后期对疾病认知的加深,抗菌药物的使用逐渐规范,并兼顾抗菌药物经济性与安全性问题。

Objective To find out about the way antibacterial drugs were used in 110 discharged patients with COVID-19 in our hospital and to explore the rational use of antibacterial drugs in patients with COVID-19.Methods The data on 110 patients with COVID-19 who were discharged between January 24,2020 and February 17,2020 was collected,whose usage of antibacterial drugs,admission symptoms,results of chest CT examination and clinical classification,outcomes of etiological examination,and infection indicators were retrospectively analyzed.Results Antibacterial drugs were used in all the 110 discharged patients,special-grade antibacterial drugs were used in 52.7%of them,and the percentage of patients who used a combination of antibacterial drugs was 78.2%.The count of white blood cells was normal or somewhat low in most of these patients on admission,neutrophil counts were mostly in the normal range,and lymphocyte counts were mostly reduced to different extents.During the detection after admission,96 patients(87.3%)had normal procalcitonin(PCT)values,and 94(85.5%)maintained normal PCT throughout the treatment.Conclusion In the early stage of the COVID-19 outbreak,the combined use of broad-spectrum antibacterial drugs and the use of special grade antibacterial drugs were quite common.With a better understanding of this disease later on,the use of antibacterial drugs was gradually standardized,while the cost and safety of antibacterial drugs were also taken into account.