新型冠状病毒感染住院患者抗菌药物合理性使用分析

Rationality of Use of Antibiotics in Inpatients with COVID-19

目的调查新型冠状病毒感染患者抗菌药物使用情况,并分析其用药合理性,为抗菌药物合理使用提供参考。方法收集某医院2023年1月呼吸内科新型冠状病毒患者的病例资料,对抗菌药物使用情况、感染相关指标、病原学检查结果进行统计分析,对抗菌药物使用合理性进行点评。结果共纳入170例患者,男性111例(65.29%),女性59例(34.71%);平均年龄(73.56±14.18)岁。有149例患者使用抗菌药物,抗菌药物使用率87.65%;实验室检查结果中,白细胞计数升高74例(49.66%),C反应蛋白升高113例(75.84%),降钙素原>0.5 ng·ml^(-1)22例(14.70%);微生物培养细菌阳性21例(16.8%)。用药频度最高的药品是注射用哌拉西林钠-他唑巴坦钠,其次是盐酸莫西沙星氯化钠注射液。有22例(13.42%)存在抗菌药物使用不合理,主要为用法用量不适宜(8.72%)和使用指征不充分(3.36%)。结论该院新型冠状病毒患者抗菌药物使用率高,抗菌药物选择起点较高,部分患者存在不合理使用情况。临床应严格把握抗菌药物使用指征,加强病原学监测,避免不合理使用抗菌药物。

Objective To investigate the usage of antibiotics in inpatients infected with COVID-19 and analyze the rationality so as to provide references for rational use of antibiotics.Methods The clinical data of COVID-19 patients in a hospital was collected,and the usage of antibiotics,infection-related indicators and results of etiological examination were statistically analyzed.The rationality of antimicrobial use was determined.Results A total of 170 patients were included,with 111 males(65.29%)and 59 females(34.71%).The average age was(73.56±14.18)years.Among these patients,149(87.65%)were treated with antibiotics.According to the results of laboratory examination,there were 74(49.66%)cases with elevated white blood cells,113(75.84%)with elevated C-reactive protein,22(14.70%)with procalcitonin levels above 0.5 ng·ml^(-1)and 21(16.8%)cases who were positive for microbial culture.The drug with the highest defend daily doses was piperacillin sodium and tazobactam sodium injection,followed by moxifloxacin hydrochloride and sodium chloride injection.Irrational use of antibiotics was found in 22(13.42%)cases,involving inappropriate dosage(8.72%)and insufficient indications for use(3.36%).Conclusion The usage of antibiotics in COVID-19 patients is high.There exists irrational use of antibiotics in some patients.Clinicians should have an intimate knowledge of the indications of antibiotics use,strengthen etiological monitoring,and avoid haphazard or inappropriate use of antibiotics.