新疆某医院老年社区获得性肺炎住院患者抗菌药物使用情况调查

Investigation of antibacterial drug use in elderly patients with community-acquired pneumonia in a tertiary general hospital in Xinjiang

目的探讨老年社区获得性肺炎(CAP)患者的用药特点,为规范老年CAP合理使用抗菌药物提供一定的参考。方法收集2019年收治的1211例CAP患者的病例资料,将老年CAP患者(≥65岁)的抗菌药物使用情况、给药时间、住院费用、药品费用、抗菌药物费用、送检标本、病原菌种类等进行分析。结果1211份病例中,重症患者527例,占43.58%,非重症患者684例,占56.42%。重症CAP患者抗菌药物使用率为99.24%(523/527),非重症CAP患者抗菌药物使用率为97.66%(668/684);抗菌药物使用以氟喹诺酮类及β-内酰胺类为主;老年CAP患者多数有联合用药,使用2种及2种以上者298例,占24.61%;病原学阳性检出率分别为重症患者35.78%、非重症患者13.59%;老年CAP患者致病体以革兰阴性菌为主,占58.93%,其中以大肠埃希菌所占比例最高(22.36%)。结论通过对比2019年度老年CAP重症患者和非重症患者的抗菌药物使用情况分析,老年CAP患者抗菌药物应用基本合理,为其他医院老年CAP患者使用抗菌药物提供一定的参考依据。

Objective To investigate the medication characteristics for elderly patients with community-acquired pneumonia(CAP),so as to provide a reference for standardizing the rational use of antibacterial drugs for elderly patients with CAP.Methods The clinical data of 1,211 patients with CAP who were treated in our hospital in 2019 were collected,and the use of antibacterial drugs,administration time,hospitalization costs,drug costs,antibacterial costs,specimens submitted for inspection,and types of pathogens in elderly CAP patients(≥65 years old)were analyzed.Results Of the 1,211 patients,there were 527 severe cases,accounting for 43.58%,and there were 684 non-critically ill patients,accounting for 56.42%.The use rate of antibacterial drugs in patients with severe CAP was 99.24%(523/527),which in patients with non-severe CAP was 97.66%(668/684).The antibacterial drugs were mainly fluoroquinolones andβ-lactams,and most elderly patients with CAP had combined medication,and 298 cases used two or more kinds of drugs,accounting for 24.61%.The pathogenic positive detection rate was 35.78%for severe patients and 13.59%for non-severe patients.The main pathogens in elderly patients with CAP were Gram-negative bacteria,accounting for 58.93%,in which,Escherichia coli had the highest proportion(22.36%).Conclusion The results show that the application of antibacterial drugs in elderly patients with CAP in our hospital is basically reasonable,which provides a certain reference for the use of antibacterial drugs in elderly patients with CAP in the other hospitals.