某院抗菌药物相关药物不良反应的临床特征分析与应对策略

Analysis of Clinical Characteristics of Adverse Drug Reactions Related to Antibacterial Drugs in a Hospital and Response Strategies

目的:分析医院抗菌药物相关药物不良反应(adverse drug reactions,ADRs)的临床特征,并提出应对策略,为临床抗菌药物的用药安全提供参考。方法:选取2017年11月—2020年10月永安市曹远卫生院238例使用抗菌药物发生ADRs的患者作为研究对象,统计不同年龄段患者抗菌药物ADRs的发生率,分析导致ADRs的主要抗菌药物种类、患者临床表现与发生原因、减少药源性损害的措施。结果:238例患者中,使用抗菌药物所致ADRs患者的年龄多为60岁以上,其次为>50~60岁、18~30岁;使用抗菌药物所致ADRs患者应用品种为头孢菌素类98例(占41.18%),青霉素类47例(占19.75%);发生ADRs患者累及系统主要为皮肤组织72例(占30.25%),具体表现为丘疹、皮肤发痒、红肿等症状,消化系统58例(占24.37%),具体表现为腹部疼痛、恶心、呕吐、腹胀等症状,神经系统47例(占19.75%),临床表现主要为眩晕、头痛不适、失眠等症状;抗菌药物ADRs发生原因主要为未开展药敏试验161例(占67.65%)、使用剂量过大56例(占23.53%)、无指征用药11例(占4.62%)。结论:抗菌药物ADRs发生率在不同年龄段存在差异性,且受药物种类影响,患者常出现不同程度的临床症状,临床应采取多种措施保证抗菌药物的合理使用,减少药源性损害,提升用药安全性。

Objective:To analyze the clinical characteristics of adverse drug reactions(ADRs)related to antibacterial drugs in the hospital and propose response strategies,so as to provide reference for safe use of antibacterial drugs in clinical practice.Methods:A total of 238 patients who developed ADR after using antibacterial drugs at Yong'an Caoyuan Health Center from November 2017 to October 2020 were selected as the research objects.The incidence of ADR after using antibacterial drugs in patients of different age groups was counted to analyze the main types of antibacterial drugs that caused ADR,clinical manifestations and causes of patients,and measures to reduce drug-induced damage.Results:Among the 238 patients,the majority of ADR patients caused by antibacterial drugs were over 60 years old,followed by>50-60 years old and 18-30 years old.Among the varieties of antibacterial drugs used,there were 98 cases of cephalosporins(41.18%)and 47 cases of penicillin(19.75%).A total of 72 cases(30.25%)of ADR patients mainly involved skin tissue,with symptoms such as papules,itching,redness and swelling,58 cases(24.37%)of the digestive system,with symptoms such as abdominal pain,nausea,vomiting and abdominal distension,and 47 cases(19.75%)of the nervous system,with main clinical manifestations such as dizziness,headache,discomfort and insomnia.The main causes of antibacterial ADR were 161 cases(67.65%)without conducting drug susceptibility tests,56 cases(23.53%)with excessive dosage and 11 cases(4.62%)with no indication of medication.Conclusion:The incidence of antibacterial ADR varies among different age groups,and patients often experience different degrees of clinical symptoms due to the influence of drug types.Multiple clinical measures should be taken to ensure the rational use of antibacterial drugs,reduce drug-induced damage,and improve medication safety.