某院替加环素专档管理及合理用药情况分析

Specialized Management and Rationality Analysis of Tigecycline in a Hospital

目的 促进替加环素的临床合理使用,规范其专档管理。方法 回顾性分析医院2018年1月至2020年12月使用替加环素的住院患者病历资料120份,统计患者的一般资料、感染部位、病原学检查结果、用药情况、临床疗效、给药疗程、药品不良反应(ADR)、超药品说明书用药等,评价用药合理性,并分析用药不合理及疗效不佳的原因。结果120例患者中,治疗总有效率为43.33%(52/120),肺部感染率为70.00%(84/120);病原学标本送检率为100%,其中阳性结果 76份,主要用于治疗鲍曼不动杆菌感染(53.95%);单用替加环素30例,主要联用头孢哌酮舒巴坦、阿米卡星、环丙沙星,分别为27例、26例、12例;给药疗程不超过3 d的44例(36.67%);替加环素使用合理87例(72.50%),发生ADR 6例(5.00%)。替加环素的使用存在少量不合理现象,原因主要为医师使用替加环素后未及时进行专档管理登记;临床疗效欠佳的原因主要为给药疗程过短。结论 该院替加环素的专档管理率较高,通过对使用替加环素的所有患者实施全样本量全程化监管,可及时发现用药问题,提高合理用药水平。

ObjectiveTo promote the clinical rational use of tigecycline,and to standardize its specialized management.MethodsA total of 120 medical records of inpatients treated with tigecycline in the hospital from January 2018 to December 2020 were analyzed retrospectively. The general data,infection part,etiological examination result,drug use,clinical efficacy,treatment course,adverse drug reaction(ADR) and off-label drug use of the patients were counted to evaluate the rationality of drug use,and analyze the reasons for unreasonable drug use and poor efficacy.Results treatment was 43. 33%(52/120),and the pulmonary infection rate was 70. 00%(84/120). The examination rate of pathogenic specimens was 100%,of which 76 specimens were positive,and tigecycline was mainly used to treat Acinetobacter baumannii infection(53. 95%). A total of 30 cases were treated with tigecycline alone,while 27 cases were treated with tigecycline,cefoperazone and sulbactam,26 cases were treated with tigecycline and amikacin,and 12 cases were treated with tigecycline and ciprofloxacin. Forty-four cases(36. 67%) were treated for less than 3 d. Eighty-seven cases(72. 50%) used tigecycline reasonably,while six cases(5. 00%) had ADR. There were a few unreasonable problems in the use of tigecycline,mainly due to the fact that physicians did not conduct the specialized management registration in time after using tigecycline. The main reason for poor clinical efficacy was the too short course of treatment.Conclusion hospital is high. Through the implementation of full-sample and whole-process supervision on all patients treated with tigecycline,we can find the drug use problems in time to promote the rational drug use.