临床药师干预对院内多重耐药感染患者合理应用抗生素的效果研究

Effect of clinical pharmacist intervention on rational application of antibiotics in patients with multidrug resistant infection in hospital

目的探讨临床药师干预对院内多重耐药感染患者合理应用抗生素的应用效果。方法选取2019年1—12月肇庆市中医院(我院)收治的95例多重耐药感染患者为对照组,选取2020年1—12月我院收治的95例多重耐药感染患者为观察组。对照组按照常规用药管理,观察组在常规用药管理的基础上予以临床药师干预。比较两组抗生素不合理用药情况、抗生素使用情况、临床疗效、不良反应发生情况、再感染及院内病死率。结果观察组用药剂量或时间不合理率、联合用药不合理率、溶媒用量不合理率均低于对照组,差异有统计学意义(P<0.05)。观察组使用抗生素种类>3类的占比、抗生素使用时间、抗生素治疗费用均低于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率、再感染发生率均低于对照组,差异有统计学意义(P<0.05),但两组患者院内病死率比较,差异无统计学意义(P>0.05)。结论临床药师干预有助于减少院内多重耐药感染患者抗生素不合理应用情况,缩短抗生素使用时间,提高治疗效果,降低不良反应的发生。

Objective To explore the effect of clinical pharmacist intervention on rational application of antibiotics in patients with multidrug resistant infection in hospital.Methods A total of 95 patients with multidrug resistance infection treated in Zhaoqing Hospital of Traditional Chinese Medicine(our hospital)from January to December 2019 were selected as the control group,and 95 patients with multidrug resistance infection treated in our hospital from January to December 2020 were selected as the observation group.The control group was managed according to routine medication,and the observation group was intervened by clinical pharmacists on the basis of routine medication management.The irrational use of antibiotics,antibiotic use,clinical efficacy,adverse reactions,reinfection and hospital death were compared between the two groups.Results The incidence of unreasonable dosage or time,unreasonable combination medication and unreasonable amout of solvent in the observation group was lower than that in the control group,with statistically significant differences(P<0.05).The proportion of using more than three types of antibiotics,the use time of antibiotics,and the cost of antibiotic treatment in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group,with statistically significant differences(P<0.05).The total incidence of adverse reactions and the incidence of reinfection in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05),but there was no significant difference in the incidence of hospital death between the two groups(P>0.05).Conclusion Clinical pharmacist intervention can help to reduce the unreasonable application of antibiotics in patients with multidrug-resistant infection,shorten the use time of antibiotics,improve the treatment effect and reduce the occurrence of adverse reactions.