莫西沙星注射液在老年患者中的用药合理性与安全性评价

Evaluation on rationality and safety of moxifloxacin injection in elderly patients

目的评价莫西沙星注射液在老年患者中的用药合理性与安全性。方法选取2019年6月-2020年3月齐河县人民医院收治的接受莫西沙星注射液治疗的患者360例,分析患者病原学检查结果、用药不合理因素、临床治疗效果及药物不良反应发生情况。结果所有患者中送病原学检查219例,送检率60.83%;且2种样本采集有15例,总计样本234份。样本以痰样本为主,其次为血液样本。234份标本中检出特异性病原菌(白色念珠菌和草绿色链球菌不计入阳性范围)70份,检出率29.91%,血液样本中未检出病原菌。用药不合理因素主要包括药物选择不当、用药指征错误、药物配伍不当和用药疗程不当等。同时,360例患者中治愈105例(29.17%)、显效201例(55.83%)、有效35例(9.72%)、无效19例(5.28%),总有效率为94.72%。患者中出现不良反应76例(21.11%):包括血钾降低43例,QT间期延长15例,皮疹及药疹10例,胃肠道不适8例,其他10例。其中出现2种不良反应的患者为10例,血钾降低及QT间期延长为主要不良反应。结论临床在采用莫西沙星为患者治疗前,应先对患者情况进行评估,严格掌控用药适应证、禁忌证,并密切留意患者有无发生不良反应,确保患者用药安全性与合理性。

Objective To evaluate the rationality and safety of moxifloxacin injection in elderly patients. Methods From June 2019 to March 2020,360 patients with moxifloxacin injection were selected in the People’ s Hospital of Qihe County. The etiological examination results,irrational drug use factors,clinical treatment effect and adverse drug reactions were analyzed. Results In all patients,219 cases were sent for etiological examination,with a submission rate of 60. 83%.15 cases were collected with two kinds of samples at the same time,with a total of 234 samples. Sputum samples were the main samples,followed by blood samples. 70 specific pathogens were detected in 234 samples( Candida albicans and Streptococcus viridis were not included in the positive range),the detection rate was 29. 91%,and no pathogens were detected in blood samples. Irrational drug use mainly included improper drug selection,wrong indications,improper drug compatibility and improper course of treatment. Among 360 patients,105 cases( 29. 17%) were cured,201 cases( 55. 83%) were markedly effective,35 cases( 9. 72%) were effective,19 cases( 5. 28%) were ineffective,and the total effective rate was94. 72%. There were 76 cases( 21. 11%) of adverse reactions,including 43 cases of hypokalemia,15 cases of QT prolongation,10 cases of skin rash and drug eruption,8 cases of gastrointestinal discomfort and 10 other cases. Among them,10 patients had two kinds of adverse reactions. The main adverse reactions were decreased serum potassium and prolonged QT interval. Conclusion Before clinical treatment with moxifloxacin for patients,we should first evaluate the patient’s situation,strictly control the indications and contraindications of medication,and pay close attention to whether there are adverse reactions after medication,so as to ensure the safety and rationality of medication.