459例住院患者替加环素临床应用分析

Clinical Application of Tigecycline in 459 Inpatients

目的:探讨该院住院患者替加环素的使用合理性,以期为替加环素的临床应用提供合理化建议。方法:提取2018—2021年该院459例使用替加环素的住院患者的病例资料,根据《替加环素临床应用评价细则》、药品说明书及专家共识采取扣分制,分别对患者基本信息、用药情况、联合用药情况、病原学检查进行合理用药统计分析。结果:459例使用替加环素的住院患者年龄为28~103岁,平均用药疗程为(8.33±6.97)d;患者主要分布在重症医学科、急诊科及呼吸科;共检验出肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌等642株病原菌;替加环素主要用于治疗重症肺炎、皮肤及软组织感染、腹腔感染。不合理用药问题主要为特殊使用级抗菌药物缺少会诊过程、用法与用量不合理、适应证不适宜及病原学检验缺乏。结论:需进一步加强该院住院患者使用替加环素的管理,多学科协同管理,加强多科室业务学习,促进替加环素的临床合理应用。

OBJECTIVE:To probe into the application rationality of tigecycline in inpatients in the hospital,so as to provide reasonable suggestions for this clinical application of tigecycline.METHODS:Case data of 459 inpatients received tigecycline in the hospital from 2018 to 2021 were extracted,and point-deduction system was adopted to perform statistical analysis on rational medication in terms of patients'general information,medication situation,drug combined and etiological examination according to the Evaluation Rules for Clinical Application of Tigecycline,the dispensatory and the expert consensus.RESULTS:The 459 inpatients received tigecycline were aged 28 to 103 years old,and the average medication duration was(8.33±6.97)days;the patients were mainly distributed in the departments of intensive care medicine,emergency medicine and respiratory medicine;a total of 642 strains of pathogens were detected,including Klebsiella pneumoniae,Acinetobacter baumannii,and Pseudomonas aeruginosa.Tigecycline was mainly used in the treatment of severe pneumonia,skin and soft-tissue infections,and abdominal cavity infection.Problems of irrational medication mainly were the lack of consultation process for special-use antimicrobial drugs,irrational usage and dosage,inappropriate indications and the lack of pathogenetic testing.CONCLUSIONS:It is necessary to further strengthen the management of the application of tigecycline in inpatients and multidisciplinary management,reinforce multidisciplinary vocational learning,and promote the rational application of tigecycline.