淋巴瘤患者化疗继发感染抗菌用药的药师干预研究

Pharmacist intervention study on antibiotics used in lymphoma patients with secondary infection caused by chemotherapy

目的分析淋巴瘤患者化疗继发感染抗菌药物的药师干预效果,评价药学人员在抗菌药物合理使用中的干预价值。方法抽取2018年1月~12月淋巴瘤化疗继发感染病例50份为非干预组,抽取2019年1月~12月淋巴瘤化疗继发感染病例55份为干预组,药学人员对临床抗菌药物使用情况进行合理干预,使用SPSS 25.0进行统计分析。结果相较于非干预组而言,干预组的碳青霉烯类、氟喹诺酮类抗感染药物的使用率明显下降,抗生素的联用率也有下降,差异有统计学意义(P<0.05),第3代头孢菌素使用率基本持平,第4代头孢菌素使用率数值有所下降,第2代头孢使用率数值有所上升,但差异无明显统计学意义(P>0.05)。干预组检出的细菌菌株数目有所下降。干预组的抗感染药物使用时间、住院时间明显下降,抗感染费用、住院费用也出现了显著的下降。结论药学人员对恶性淋巴瘤化疗继发感染抗菌药物的干预,能显著减少抗感染药物的使用量,特别是高级别抗生素的使用量,更可以减少患者住院的费用和平均住院日,取得了良好的药物学、经济学和社会学效益。

Objective To analyze the effect of pharmacist intervention of antibiotics in patients with lymphoma secondary to chemotherapy,and to evaluate the intervention value of pharmacists in the rational use of antibiotics.Methods 50 cases of secondary infection caused by chemotherapy of lymphoma from January to December 2018 were selected as non-intervention group,and 55 cases of secondary infection of lymphoma from January to December 2019 were selected as intervention group.Pharmacists made reasonable intervention on the use of clinical antibiotics,and the results were statistically analyzed by SPSS25.0.Results Compared with the non-intervention group,the use rate of carbapenem and fluoroquinolone in the intervention group decreased significantly,and the combination use rate of antibiotics also decreased(P<0.05),and use rate of the third-generation cephalosporins was almost the same,the use rate of the fourth-generation cephalosporins decreased and the use rate of the second-generation cephalosporins increased,but the difference was not statistically significant(P>0.05).The number of bacterial strains detected in the intervention group decreased.In the intervention group,the use time of anti-infective drugs and hospitalization time decreased significantly,and the anti-infective cost and hospitalization cost also decreased significantly.Conclusion Pharmacists’intervention of antibiotics in chemotherapy infection of malignant lymphoma can significantly reduce the use of anti-infective drugs,especially high-grade antibiotics,as well as the hospitalization expenses and average hospitalization days of patients.Good pharmacological,economic and sociological benefits have been achieved.