某院发热门诊抗感染药物所致药物不良反应的流行病学特征分析与应对策略

Analysis of Epidemiological Characteristics of Adverse Drug Reactions Caused by Anti-infective Drugs in the FeveRClinic of a Hospital and Response Strategies

目的:分析医院发热门诊抗感染药物所致药物不良反应(adverse drug reactions,ADRs)的流行病学特征,并提出相应的应对策略,为抗感染药物在门诊的安全使用提供参考。方法:选取2021年1月—2022年6月南阳医专第二附属医院发热门诊上报国家药品不良反应监测系统的162例抗感染药物所致ADRs报告,采集患者的年龄、性别,相关抗感染药物的种类、给药方式,以及ADRs的发生时间、累及器官(或系统)等信息,分析抗感染药物所致ADRs的流行病学特征。结果:162例抗感染药物所致ADRs患者的男女性别分布较为均衡(87例vs 75例),而其年龄则主要集中在>60岁(73例,占45.06%);162例ADRs所涉的抗感染药物主要为抗菌药物(160例,占98.77%),其中主要的类别有头孢菌素类(44例,占27.16%)、喹诺酮类(38例,占23.46%)、大环内酯类(34例,占20.99%)和青霉素类(33例,占20.37%);162例ADRs所涉抗感染药物的给药方式主要为静脉滴注(115例,占70.99%),其次为口服(31例,占19.14%);162例ADRs主要的发生时间为用药后的>1~3 h(70例,占43.21%),其次为用药后的>5 min~1 h(45例,占27.78%)和≤5 min(30例,占18.52%);162例ADRs主要皮肤及其附件(56例,占34.57%)、胃肠道(41例,占25.31%)和神经系统(36例,占22.22%)。结论:医院发热门诊抗感染药物所致ADRs主要由静脉用抗菌药物引起,并且在老年人中更为多见,对于高发人群临床在护理和用药交代时重点关注,以确保患者的用药安全。

Objective:To analyze the epidemiological characteristics of adverse drug reactions(ADRs)caused by anti-infective drugs in the hospital feveRclinic and propose corresponding response strategies,so as to provide reference foRthe safe use of anti-infective drugs in outpatient departments.Methods:162 ADRreports caused by anti-infective drugs reported to National CenteRfoRADRMonitoring,China from the FeveRClinic of the Second Affiliated Hospital of Nanyang Medical College from January 2021 to June 2022 were selected,and information such as patient age,gender,type and method of administration of related anti-infective drugs,occurrence time and organs(oRsystems)involved of ADRs was collected to analyze the epidemiological characteristics of ADRs caused by anti-infective drugs.Results:The sex distribution of 162 patients with ADRs caused by anti-infective drugs was relatively balanced(87 cases vs 75 cases),and theiRages were mainly concentrated in eldeRthan 60 years old(73 cases,45.06%);the anti-infective drugs involved in 162 cases of ADRs were mainly antibacterial drugs(160 cases,98.77%),of which the main categories were cephalosporins(44 cases,27.16%),quinolones(38 cases,23.46%),macrolides(34 cases,20.99%)and penicillins(33 cases,20.37%);the administration methods of anti-infective drugs involved in 162 cases of ADRs were mainly intravenous drip(115 cases,70.99%),followed by oral administration(31 cases,19.14%);162 cases of ADRs mainly occurred more than 1 to 3 h afteRadministration(70 cases,43.21%),followed by more than 5 min to 1 h after administration(45 cases,27.78%),and less than oRequal to 5 min afteRadministration(30 cases,18.52%);the organs or systems involved in 162 cases of ADRs were mainly skin and its appendages(56 cases,34.57%),gastrointestinal tract(41 cases,25.31%)and nervous system(36 cases,22.22%).Conclusion:ADRs caused by anti-infective drugs in the hospital feveRclinic are mainly induced by intravenous antibacterial drugs,and are more common in the elderly.Focus on ADRs foRthe high-risk groups during clinical care and medication disclosure to ensure theiRmedication safety.