万古霉素药学监护路径建立与实施成效分析

Establishment and Effect of Pharmaceutical Care Pathways of Vancomycin

目的建立万古霉素药学监护路径,为规范化开展万古霉素药学监护以及提高万古霉素用药安全有效性提供参考。方法采用临床路径和药学监护的方法和原理,结合万古霉素的药物特点,建立万古霉素药学监护路径,并应用于在院患者的监护,通过对比监护路径实施前后的万古霉素血药谷浓度的监测率、达标率和治疗有效率情况,探讨实施成效。结果实施万古霉素药学监护路径后,万古霉素血药谷浓度的监测率与治疗有效率分别为54.14%和83.53%,较实施前明显提高(P<0.05);但血药谷浓度达标率为55.88%,较实施前变化不大(P>0.05),考虑与实施后万古霉素血药谷浓度监测例数增加较多、部分患者剂量未调整以及更改抗感染药物相关。结论万古霉素药学监护路径实施后,万古霉素的治疗应用更加规范,血药谷浓度的监测率和治疗有效率明显提高。

Objective To establish a pharmaceutical care pathway for vancomycin,provide reference for standardizing related pharmaceutical care and improve the safety and effectiveness of vancomycin administration.Methods In line with the principles and methods of clinical pathways and pharmaceutical care and with reference to the characteristics of vancomycin,a pharmaceutical care pathway was established for vancomycin and applied to the care of inpatients.The effectiveness was assessed by comparing the monitoring rate,attainment rate and efficiency of trough concentrations of vancomycin before and after the implementation of the care pathway.Results After the implementation of the vancomycin pharmaceutical care pathway,the monitoring rate of vancomycin trough concentrations and the clinical effective rate were 54.14%and 83.53%,respectively,which were significantly higher than before the implementation(P<0.05).However,the attainment rate of trough concentrations was 55.88%,and the changes were insignificant(P>0.05),which was considered to be related to the increase in the number of cases whose trough concentrations of vancomycin were monitored after the implementation,failure to adjust the doses of some patients'and to the use of other anti-infective drugs.Conclusion Since the implementation of is pharmaceutical care pathway in our hospital,treatment with vancomycin has become more standardized,and the monitoring rate of trough concentrations and the clinical effective rate have been significantly improved.