社区获得性肺炎抗菌药物使用管理实践与分析

Practice and analysis of antibiotic use management in community-acquired pneumonia

目的:分析上海市普陀区人民医院临床药师参与药物使用管理工作前后,社区获得性肺炎抗菌药物的使用合理性及相关指标变化情况,为促进社区获得性肺炎抗菌药物的合理使用提供建议。方法:于2017年6月1日—2017年9月30日选取上海市普陀区人民医院87例出院患者作为对照组,于2018年6月1日—2018年9月30日选取该院55例出院患者作为干预组,所有病例均符合社区获得性肺炎诊断标准。结果:在药物选择、用药疗程、初始用药后72 h疗效评价及抗菌药物总体使用合理性方面,干预组与对照组的药物使用合理性差异有统计学意义(P<0.05),在抗菌药物平均费用、药品平均费用方面,干预组与对照组的费用差异有统计学意义(P<0.05)。结论:积极开展以合理用药为核心的药事服务对医院药事管理的健康发展起着至关重要的作用,临床药师不仅可以为医务人员及患者提供有效药学服务,并且能够在确保高质量医疗水平的前提下,提升用药安全、降低治疗费用,促进医疗资源的合理利用。

Objective:To analyze the rational use of antibiotics and the changes of related indicators in communityacquired pneumonia before and after the participation of clinical pharmacists in drug use management in People’s Hospital,Putuo District,Shanghai to provide suggestion for promoting the rational use of antibiotics in community-acquired pneumonia.Methods:From June 1,to September 30,2017,87 patients discharged from People’s Hospital of Putuo District,Shanghai were selected as the control group,and from June 1,to September 30,2018,55 patients discharged from the hospital were selected as the intervention group.All the patients met the diagnostic criteria for community-acquired pneumonia.Results:In terms of drug selection,medication course,efficacy evaluation 72 hours after initial medication,and overall rationality of antibacterial drug use,there were statistically significant differences in the rationality of drug use between the intervention group and the control group(P<0.05);in terms of the average cost of antibacterial drugs and the average cost of drugs,the cost difference between the intervention group and the control group was statistically significant(P<0.05).Conclusion:Actively carrying out pharmaceutical service with rational drug use as the core plays a vital role in the healthy development of hospital pharmaceutical management,and clinical pharmacists can not only provide effective pharmaceutical care for medical staff and patients,but also improve medication safety,reduce treatment costs and promote the rational use of medical resources on the premise of ensuring highquality medical level.