回顾分析广东某院儿童社区获得性肺炎用药情况

Retrospective Analysis of Drug Use in Children with Community-acquired Pneumonia in a Hospital in Guangdong

目的儿童社区获得性肺炎是儿科乃至基层住院患者数量排行第一的病种而且是国家单病种上报内容。如何更好地为该类患者提供高质量的药学服务,减轻患者负担,提高单病种的医疗质量以及群众满意度是药学部门必须思考的问题。方法从医院信息系统导出儿科2020年1月~2023年6月出院患者数据,根据儿童社区获得性肺炎标准筛选患者入组4980人次。采用回顾性分析法对儿童年龄分布,住院时长,抗菌药物使用比例,输液比例,药品使用DDDs情况以及前置审方系统数据进行分析。结果儿童社区获得性肺炎主要年龄分布在29 d至5岁;患儿住院期间人均输液27瓶,输液量1500 mL;使用频次前10名药品,主要以平喘、化痰、抗病毒、抗菌药为主。其中抗菌药物使用比例达93%~99%,使用强度为22~26;前置审方系统提示药品用法、用量、存在问题有的属于假阳性。结论应加强儿童健康科普宣教;患儿输液量可以通过调整药品供应策略,适当减少输液量;对于使用频次靠前的品种,在春冬季呼吸疾病高发季节应进行战略性储备;前置审方系统自带规则有局限性应根据实际情况进行修订。

OBJECTIVE Community-acquired pneumonia in children is the number one inpatient disease in pediatrics and even in our hospital and it is a nationally reported single-disease.How to better provide high-quality pharmacy services for this type of patients,reduce the burden of patients,improve the quality of single-disease care and public satisfaction is a problem that our pharmacy department must adress.METHODS The data of discharged patients in pediatrics from January 2020 to June 2023 were derived from the hospital information system.And 4980 patients were screened and enrolled according to the national criteria for community-acquired pneumonia in children with single-disease category.Retrospective analysis was conducted on the children's age distribution,length of hospital stay,proportion of antimicrobial use,proportion of infusion,DDDs of drug use and data of pre-trial system.RESULTS The main age distribution of community-acquired pneumonia in children was from 29 days to 5 years old..During hospitalization,27 bottles of intravenous infusion were administered per child,with an infusion volume of 1500 mL.And the top 10 medicines in the frequency of use were mainly asthma-relieving,phlegm-reducing,antiviral,and antibacterial drugs.In this disease,the proportion of antimicrobial drug use reached 93%-99%,with an intensity of 22-26.The pre-trial system indicates that some of the usage,dosage,and any issues with the drug may be false positives.CONCLUSION Children's health popularization of science and education should be strengthened,and the amount of children's infusion can be further reduced by adjusting the drug supply strategy.For varieties with higher frequency of use,strategic stockpiling should be carried out during the high incidence season of respiratory diseases in spring and winter.The rules of the pre-trial system have limitations and should be revised according to the actual situation.