儿科门诊应用微生态制剂的合理性与安全性分析

Rationality and safety analysis of probioties in pediatric outpatient applications

目的了解医院微生态制剂临床应用合理性与安全性现状,为儿童合理应用提供参考。方法通过医院信息系统,检索2022年1-12月苏州大学附属儿童医院含微生态制剂的门诊处方,并根据处方审核建议进行分析。结果共筛选出含微生态制剂的处方236604张,包含酪酸梭菌二联活菌散等7种微生态制剂。其中,超适应证用药处方共61549张,占26.01%;非常规剂量用药处方共103666张,占46.94%,其中剂量过大处方数占81.10%,剂量不足处方数仅占18.90%;复方嗜酸乳杆菌片及酪酸梭菌二联活菌胶囊为幼儿期群体开具的处方有2084张,占总处方数的0.88%;临床应用中有重复用药的情况,但处方数所占比例不足1%。结论微生态制剂在儿童中超适应证用药的发生率较高,用药有循证医学证据均较低。用药规范程度有待提升,无论是在用药剂量还是用药剂型的选择上。微生态制剂在儿童疾病的扩大应用研究需更多更可靠的研究证据,且应尽可能规范处方行为,促进合理用药。

Objective To investigate the rationality and safety status of clinical application of probioties in our hospital,and to provide reference for the rational application of children.Methods The outpatient and emergency prescriptions containing probioties in our hospital during January to December 2022 were enrolled through the hospital information system,and analyzed according to the prescription review recommendations.Results A total of 236604 prescriptions containing probioties were screened,including 7 kinds of probioties such as Combined Clostridium Butyricum and Bifidobacterium Powders.Among them,there were 61549 out-of-indication drug prescriptions,accounting for 26.01%.There were 103666 non-conventional dose prescriptions,accounting for 46.94%,among which over-dose prescriptions accounted for 81.10%and under-dose prescriptions only accounted for 18.90%.There were 2084 prescriptions of Compound Eosinophil-Lactobacillus Tablets and Combined Clostridium Butyricum and Bifidobacterium Capsules were prescribed for infants,accounting for 0.88%of the total prescriptions.There were cases of repeated drug use in clinical application,but the proportion of prescription was less than 1%.Conclusion The incidence of out-of-indication drug use of probioties in children is high,and the evidence-based medical evidence for medication is low.The degree of medication standardization needs to be improved,whether in the choice of medication dose or dosage form.Further reliable research evidence is needed for the expansion of probioties in childhood diseases,and the prescribing behavior should be standardized as much as possible to promote rational drug use.