2705份病历碳青霉烯类抗菌药物应用分析

Analysis on the Application of Carbapenems in 2 705 Pieces of Medical History

目的:了解巩义市人民医院(以下简称"我院")碳青霉烯类抗菌药物的应用情况,为碳青霉烯类抗菌药物的临床应用和监管提供依据。方法:抽取我院2016年7月至2018年6月共2 705份使用碳青霉烯类抗菌药物的病历,对该类药物临床使用情况进行统计分析。结果:2017年7月至2018年6月,我院碳青霉烯类抗菌药物的销售金额从2016年7月至2017年6月的362.77万元增至548.36万元,用药频度(defined daily dose system,DDDs)从8 216.76增至13 268.5,使用强度从1.64 DDDs/(100人·d)增至2.20 DDDs/(100人·d),增幅均较大;2 705份使用碳青霉烯类抗菌药物的病历中,使用美罗培南的有2 456份,使用亚胺培南的有108份,使用比阿培南的有141份;临床耐药革兰阴性菌增加,美罗培南临床抗感染效力降低,细菌对其的敏感性降低,需要应用新型碳青霉烯类抗菌药物比阿培南。结论:我院碳青霉烯类抗菌药物的应用基本合理,继续加强管理,尤其加强新型碳青霉烯类抗菌药物比阿培南的管理,减少细菌耐药性的产生。

OBJECTIVE:To investigate the application of carbapenems in Gongyi City People's Hospital(hereinafter referred to as“our hospital”),so as to provide references for clinical application and supervision on carbapenems.METHODS:2 705 pieces of medical history with application of carbapenems from Jul.2016 to Jun.2018 in our hospital were extracted and analyzed.RESULTS:From Jul.2017 to Jun.2018,the consumption sum of carbapenems in our hospital had risen from 3.627 7 million yuan during Jul.2016-Jun.2017 to 5.483 6 million yuan,the defined daily dose system(DDDs)had risen from 8 216.76 to 13 268.5,antibiotics use density had risen from 1.64 DDDs/(100 people·d)to 2.20 DDDs/(100 people·d),all with significant increasing;of the 2 705 pieces of medical history with application of carbapenems,2 456 were meropenem,108 were imipenem and 141 were biapenem;the number of gram-negative bacteria had increased,the clinical anti-infective efficacy to meropenem and the sensitivity of bacteria had been reduced,which need to apply biapenem,the new type of carbapenem.CONCLUSION:The application of carbapenem in our hospital is basically reasonable,the application of biapenem should be especially strengthened to reduce bacterial resistance.