美罗培南临床应用综合评价分析

Comprehensive Evaluation and Analysis of Meropenem

目的:探讨评价分析住院患者美罗培南临床应用合理性情况的方法。方法:回顾性分析抽查某院2017~2019年应用美罗培南的43例患者用药。依据患者病情转归结果分别计算用药频度(DDDs)和药物利用指数(DUI);采用临床肺部感染评分(CPIS)评估肺部感染用药适宜性;结合处方专项点评指南评估其他用药不适宜问题。结果:平均DUI为1.92,其中死亡组DUI为2.11;死亡组CPIS高于生存组,治疗好转组和无好转或恶化组的CPIS差异不大,但好转组用药后的CPIS有所下降。其他不适宜问题包括药物配伍禁忌、相互作用和联用药品的不良反应风险。结论:药物综合评价应多维度、分层次,以降低患者用药风险为目的,DUI和CPIS可作为恰当选择和适时停用美罗培南的重要依据。

Objective:To discuss the methods used to evaluate the application of meropenem in inpatients.Methods:A retrospective analysis of 43 cases of patients with application of meropenem in a hospital from June 2017 to July 2017 was carried out in the current study.Calculating medication frequency(DDDs)and medication usage index(DUI)were calculated according to the outcome of illness.Evaluation of the rationality of drug usage in pulmonary infection was analyzed based on the Clinical pulmonary infection score(CPIS).And prescription special evaluation guideline was used to evaluate other impropriate drug administration problems.Results:Of all 43 patients,the average DUI is 1.92.The DUI of patients who died after therapy is 2.11.The CPIS of patients who died is higer than that of the patients survived.There is little difference of CPIS between patient with improved condition or with deteriorate condition after treatment.But there is obvious decline of CPIS in patient with improved condition.Other inappropriate drug use related problems includes risks caused by drug incompatibility,drug interaction and drug combination.Conclusions:Multi-dimension and multi-delamination should be introduced in the evaluation and analysis system of drugs use.The goal of the evaluation is to reduce the risk of impropriate prescription.DUI combined with CPIS could be an important indication for the selection and suspension of meropenem.