95例住院患者艰难梭菌感染初始用药分析

Analysis of initial medications for Clostridium difficile infection in 95 inpatients

目的:分析我院住院患者艰难梭菌感染(Clostridium difficile infection,CDI)的初始用药情况,为临床合理用药提供参考。方法:收集我院2017年4月–2019年12月诊断为CDI住院患者病例信息,共计95例,评价CDI治疗的初始用药方案、给药途径、疗程、用法用量的合理性及治疗方案有效性、安全性。结果:我院目前治疗CDI的药物有甲硝唑与万古霉素,两种药物组成5种初始治疗方案,不合理率为9.47%;用药疗程不合理率49.47%;甲硝唑用法用量不合理率为91.38%,万古霉素用法用量不合理率为44.44%。95例患者治疗总体有效率72.63%,失败率10.53%,复发率10.53%,死亡率7.37%,甲硝唑不良反应发生率6.90%。结论:我院CDI治疗的初始用药尚不规范,需进一步加强管理,促进其在临床合理使用。

Objective:To analyze the initial medications for Clostridium difficile infection(CDI)in hospitalized patients in our hospital in order to provide references for rational drug use.Methods:Data of a total of 95 inpatients diagnosed with CDI in our hospital from April 2017 to December 2019 were collected and analyzed in terms of the rationality,efficacy and safety of the initial medication regimen.Results:At present,there were 5 initial medication regimens composed by metronidazole and vancomycin for CDI in our hospital,among which the irrational rate was account for 9.47%.Rate of unreasonable medication course was 49.47%.Rate of the irrational use of metronidazole and vancomycin were 91.38%and 44.44%respectively.The total effective rate and the failure rate in 95 patients were 72.63%and 10.53%respectively.The recurrence rate of CDI was 10.53%and the mortality rate was 7.37%.The incidence rate of adverse drug reactions induced by metronidazole was 6.90%.Conclusion:The initial medication for CDI in our hospital was not standardized yet,which should be further managed to promote rational drug use.