临床药师参与重症监护室重症感染患者抗感染治疗效果研究

Study on the effect of clinical pharmacists participating in anti-infection treatment for severe infection patients in the intensive care unit

目的探讨临床药师参与重症监护室(ICU)重症感染患者抗感染治疗的效果。方法通过医院信息系统回顾性收集2023年1—6月济南市第四人民医院ICU收治的重症感染患者,其中临床药师全程参与抗感染治疗的患者为干预组,临床药师未参与治疗的患者为对照组,2组患者均按照临床诊断给予常规治疗。比较2组患者的治愈率、不良反应发生率、抗菌药物费用、抗菌药物费用占比、病原学送检率、抗菌药物应用疗程和患者平均住院日等指标。结果共纳入147例患者,其中干预组66例,对照组81例。干预组患者治愈率为65.15%,显著高于对照组的46.91%(P<0.05);干预组不良反应发生率(7.58%)显著低于对照组(19.75%)(P<0.05)。干预组喹诺酮类药物和替加环素的使用率显著降低,抗菌药物费用、抗菌药物费用占比、患者病原学送检率等指标均明显优于对照组(P<0.05)。2组抗菌药物应用疗程、平均住院日差异无统计学意义(P>0.05)。结论临床药师全程参与ICU重症感染患者的抗感染治疗,有助于提高患者的临床治愈率和用药安全性,减轻患者医疗负担。

Objective To explore the effectiveness of clinical pharmacists participating in anti-infection treatment for severe infection patients in the intensive care unit.Methods A retrospective collection of severe infection patients admitted to the ICU of the Fourth People's Hospital of Jinan from January to June 2023 was conducted through the hospital information system.Among them,some patients with clinical pharmacists participating in anti-infection treatment throughout the process were in the intervention group,and other patients who did not participate in treatment were in the control group.Both groups of patients received routine treatment according to clinical diagnosis.We compared the cure rate,incidence of adverse reactions,cost of antibiotics,proportion of antibiotic costs,pathogen testing rate,duration of antibiotic treatment,and average length of hospital stay between two groups of patients,and conducted statistical analysis.Results A total of 147 patients were included,with 66 in the intervention group and 81 in the control group.The cure rate of patients in the intervention group was 65.15%,significantly higher than 46.91%in the control group(P<0.05);The incidence of adverse reactions(7.58%)was significantly lower than that of the control group(19.75%)(P<0.05).The usage rates of quinolone drugs and tigecycline were significantly reduced in the intervention group;The intervention group had significantly better indicators such as antibiotic costs,proportion of antibiotic costs,and patient pathogen testing rate than the control group(P<0.05).There were no significant difference in the duration of antimicrobial treatment and average length of hospital stay between the two groups(P>0.05).Conclusion The full participation of clinical pharmacists in the anti-infection treatment of ICU severe infection patients can help improve their clinical cure rate and medication safety,and reduce their medical burden.