某综合性三甲医院抗真菌药物使用情况分析

Analysis of the Application of Antifungal Drugs in a Tertiary Class General Hospitals

目的分析某综合性三甲医院抗真菌药物使用情况,促进抗真菌药物的合理使用。方法回顾性分析2019年3月~2020年12月某综合性三甲医院使用过抗真菌药物氟康唑、伏立康唑、伊曲康唑、卡泊芬净以及两性霉素B的病例共900例,收集患者相关信息,并进行统计分析。结果抗真菌药物使用最多的科室是呼吸内科、血液内科,患者常合并多种基础疾病,最常见的基础疾病是高血压、肺部感染、糖尿病、血液系统恶性肿瘤和慢性阻塞性肺病。抗真菌药物使用平均疗程为(9.28±7.83)d,239例患者有使用负荷剂量。抗真菌药物使用前病原学送检比例为84.78%,送检最多的微生物培养是痰培养,无菌标本送检相对较少,占28.44%,常见的真菌是白色念珠菌和烟曲霉。抗真菌药物使用量最多的是氟康唑,其次是伏立康唑。抗真菌药物使用评价不合理率为2.11%,主要不合理现象为:①遴选药品不适宜;②给药途径不适宜;③用法用量不适宜。结论临床实践中需进一步提高抗真菌药物使用的科学性和规范性。

OBJECTIVE To analyze the use of antifungal drugs in a tertiary class general hospital and promote the rational use of antifungal drugs.METHODS A retrospective investigation of 900 cases of antifungal drugs(fluconazole,voriconazole,itraconazole,caspofungin,amphotericin B)in a tertiary class general hospital from March 2019 to December 2020.Collect patient-related information and perform statistical analysis.RESULTS The departments that used most antifungal drugs were respiratory medicine and hematology.Patients often have multiple underlying diseases,the most common underlying diseases are hypertension,lung infection,diabetes,hematological malignancies and chronic obstructive pulmonary disease.The mean duration of antifungal drug use was(9.28±7.83)days,and 239 patients received loading doses.Before the use of antifungal drugs,the proportion of pathogens submitted for inspection was 84.78%.The most submitted microbial cultures were sputum cultures.The sterile specimens were relatively few,accounting for 28.44%.Common fungi were Candida albicans and Aspergillus fumigatus.Fluconazole is the most used antifungal drug,followed by voriconazole.The unreasonable rate of antifungal drug use evaluation was 2.11%.The main unreasonable phenomena were:(1)The selection of drugs was not suitable;(2)The route of administration was not suitable;(3)The usage and dosage were not suitable.CONCLUSION It is necessary to further improve the scientificity and standardization of the use of antifungal drugs in clinical practice.