碳青霉烯类药物临床应用评价

Evaluation of clinical application of carbapenem antibiotics

目的回顾性分析南京中医药大学附属南京医院碳青霉烯类特殊使用级抗菌药物的临床应用情况,评价该类药物使用的合理性,促进碳青霉烯类抗菌药物的合理使用。方法采用回顾性分析的方法,收集2023年1月1日—2023年6月30日在南京中医药大学附属南京医院使用碳青霉烯类抗菌药物364例住院患者的病历资料,对患者年龄、感染部位、微生物送检、病原菌培养、用药疗程、药物会诊、联合用药和患者用药后的转归等情况进行分析,并对该类药物的用药合理性进行评估。结果364例使用碳青霉烯类抗菌药物治疗的住院患者中以老年人居多,62.6%患者由于肺部感染使用该类药物治疗;用药前的微生物送检率为86.8%,主要病原菌为大肠埃希菌、肺炎克雷伯菌及铜绿假单胞菌,用药疗程和联合用药情况基本符合预期目标;会诊率低,尤其是临床药师会诊率;治疗有效病例数为311例,占比85.4%;不良反应发生率为1.65%,症状均较轻微。结论碳青霉烯类抗菌药物临床应用基本合理,对不合理情况应继续加强监管,促进该类药物的合理使用。

Objective To analyze the clinical application of carbapenem antibiotics for special use in a hospitals,analyze and evaluate the rationality of these drugs,and promote the rational use of carbapenem antibiotics.Methods A retrospective analysis was used to collect the medical records of 364 patients receiving carbapenem antibiotics in Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine from January 1,2023 to June 30,2023.The patients'age,infection site,microorganism examination,pathogen culture,drug duration,drug consultation,combined drug use and patients'prognosis after drug use were analyzed and discussed.The rationality of the drug use was evaluated.Results Most of 364 patients were aged,62.6% were treated for pulmonary infection.The rate of microbial detection before medication was 86.8%,the main pathogens were Escherichia coli and Klebsiella pneumoniae.The course of medication and the combination of medication basically met the expected target.The consultation rate is low,especially that of clinical pharmacists.The number of effective treatment cases was 311(85.4%).The incidence of adverse reactions was 1.65%,and the symptoms were mild.Conclusion The clinical application of carbapenem antibiotics in our hospital is basically reasonable,and the unreasonable situation should be further supervised to promote the rational use of carbapenems.