从社区获得性肺炎经验性抗生素治疗方案看药学服务的重要性

The importance of pharmaceutical care in treatment of community-acquired pneumonia with antibiotics

目的 :探讨对临床医师进行药学服务的必要性。 方法 :收集从 2 0 0 0年 5月～ 2 0 0 2年 5月接受呼吸科医师和内科医师抗生素治疗社区获得性肺炎 (CAP)的门诊病历 4 2 6例。统计和分析首选抗生素种类和每日给药次数 ,并与我国《社区获得性肺炎诊断和治疗指南》进行对比。 结果 :呼吸科医师和内科医师治疗 CAP的抗生素选择与《社区获得性肺炎诊断和治疗指南》有差距 ,以内科医师较为明显 ,表现为过多使用第三代头孢菌素 ,大环内酯类使用偏低 ,首选氨基糖苷类依然存在 ,且时间依赖型抗生素每日给药次数不合理。 结论 :为经济、合理、安全和有效使用药物 ,对临床医师开展药学服务指导十分重要。

Objective:To discuss the necessity of instructing physicians in pharmaceutical care. Methods: Clinical data of 426 outpatients with community-acquired pneumonia (CAP) were collected during the period from May 2000 through May 2002. The patients were treated with antibiotics. The antibiotics of first choice and daily frequency of iv administration were recorded, analyzed and compared with the guideline of diagnosis and management of CAP in China. Results: The data of antibiotic treatment were different from the guideline in the antibiotics chosen by doctors of respiratory diseases and general physicians, especially the general physician. Cefalosporins were overused, while macrolides were underutilized. The aminoglycosides were still used as the antibiotics of first choice. The daily frequency of intravenous injection was unreasonable for time-dependant antibiotics. Conclusion: It is extremely important to instruct physicians in pharmaceutical care for the purpose of achieving economical, reasonable, safe and effective drug therapy.