第三代头孢菌素类抗菌药物的药理作用及其临床合理用药情况分析

Pharmacological action and clinical rational use of the third-generation cephalosporins

目的 分析第三代头孢菌素类抗菌药物的药理作用及其临床合理用药情况。方法 分别抽选470例(470份处方)接受第一代头孢菌素类抗菌药物治疗、760例(760份处方)接受第二代头孢菌素类抗菌药物治疗、558例(558份处方)接受第三代头孢菌素类抗菌药物治疗患者的临床资料,分析三代(第一、二、三代)头孢菌素类药物使用方式、用药频度(DDDs)与费用,第三代头孢菌素类药物使用方式与剂量,第三代头孢菌素类抗菌药物治疗患者不良反应发生情况。结果 第一代头孢菌素类抗菌药物口服比例为38.51%,注射比例为61.49%;用药频度为5.66;费用为10.18万元。第二代头孢菌素类抗菌药物口服比例为28.95%,注射比例为71.05%;用药频度为16.37;费用为108.71万元。第三代头孢菌素类抗菌药物口服比例为39.07%,注射比例为60.93%;用药频度为12.01;费用为83.96万元。第三代头孢菌素类药物用药频度高于第一代,但低于第二代;第三代头孢菌素类药物的费用远高于第一代,但低于第二代。558例患者接受第三代头孢菌素类药物治疗后不良反应发生率为5.02%,其中发生少尿患者2例(0.36%)、血小板和(或)白细胞下降患者1例(0.18%)、皮疹患者2例(0.36%),其余均为消化系统不良反应,包括恶心呕吐患者17例(3.05%)、食欲不振患者5例(0.90%)以及腹泻患者1例(0.18%)。结论 与第一、二代头孢菌素类抗菌药物相比,第三代头孢菌素类抗菌药物治疗感染性疾病的效果更好,不良反应发生率低,用药安全性更高。

Objective To analyze the pharmacological action and clinical rational use of the third-generation cephalosporins.Methods Clinical data of 470 patients(470 prescriptions)receiving first-generation cephalosporins,760 patients(760 prescriptions)receiving second-generation cephalosporins,and 558 patients(558 prescriptions)receiving third-generation cephalosporins were selected.The modes of use,defined daily doses(DDDs)and cost of the first-,second-and third-generation cephalosporins,the modes and doses of third-generation cephalosporins,and the occurrence of adverse reactions in patients treated with third-generation cephalosporins were analyzed.Results The first-generation cephalosporins were administered orally at a rate of 38.51%and injected at a rate of 61.49%;the defined daily doses was 5.66;and the cost was 10.18 ten thousand yuan;the second-generation cephalosporins were administered orally at a rate of 28.95%oral and injected at a rate of 71.05%;the defined daily doses was 16.37;and the cost was 108.71 ten thousand yuan;the third-generation cephalosporins were administered orally at a rate of 39.07%and injected at a rate of 60.93%;the defined daily doses was 12.01;and the cost was 83.96 ten thousand yuan.The defined daily doses of third-generation cephalosporins was higher than that of the first-generation cephalosporins,but lower than that of the second-generation cephalosporins;the cost of third-generation cephalosporins was much higher than that of the first-generation cephalosporins,but lower than that of the second-generation cephalosporins.The incidence of adverse reactions was 5.02%in 558 patients treated with third-generation cephalosporins,including 2 patients(0.36%)with oliguria,1 patient(0.18%)with platelet and/or leukocytosis,2 patients(0.36%)with rash,and the rest were digestive system adverse reactions,including 17 patients(3.05%)with nausea and vomiting,5 patients(0.90%)with anorexia and 1 patient(0.18%)with diarrhea.Conclusion Compared with the previous two generations,the third-generation cephalosporins are more effective in disease treatment,with low incidence of adverse reactions and high drug safety.