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目的 :探讨临床药师干预对鼻咽癌同步放化疗期间口腔黏膜炎患者抗菌药物使用的影响。方法 :选取2013年三季度300例鼻咽癌同步放化疗并口腔感染患者为研究对象,随机分为对照组和观察组。观察组给予临床药师干预,对照组给予常规用药。比较两组患者抗菌药物使用情况。结果 :观察组患者青霉素类药物(青霉素G、哌拉西林他唑巴坦)使用率明显降低,硝基咪唑类药物(奥硝唑)使用率显著升高,与对照组比较差异具有统计学意义。观察组患者抗菌药物使用指征合理率、品种选择合理率、用法用量合理率、使用疗程合理率显著升高,联合用药比例、用药疗程显著降低,与对照组比较差异具有统计学意义。观察组患者抗菌药物费用、药品总费用、住院总费用均显著降低,与对照组比较差异具有统计学意义。结论 :临床药师干预可有效提高鼻咽癌同步放化疗期间口腔黏膜炎患者抗菌药物使用合理性,减少治疗费用。
Objective: To investigate the effect of clinical pharmacist intervention on the use of antimicrobial agents in patients with oral mucositis during concurrent chemoradiotherapy of nasopharyngeal carcinoma. Methods: Three hundred patients with concurrent nasopharyngeal carcinoma and oral infection in the third quarter of 2013 were selected as the research object and randomly divided into control group and observation group. The observation group was given clinical pharmacist intervention, and the control group was given routine medication. Antibiotics use was compared between the two groups. Results: The use of penicillin (penicillin G, piperacillin and tazobactam) in the observation group was significantly reduced, and the use rate of nitroimidazole (ornidazole) was significantly higher than that of the control group . The patients in the observation group showed a reasonable rate of indications for antimicrobial use, a reasonable rate of variety selection, a reasonable rate of usage and dosage, a reasonable rate of use of treatment was significantly increased, the proportion of combination therapy and medication course significantly decreased, and the difference was statistically significant compared with the control group. Antibiotics costs, total cost of medicines and total cost of hospitalization in the observation group were significantly lower than those in the control group, which were statistically significant. Conclusion: The intervention of clinical pharmacists can effectively improve the rational use of antimicrobial agents in patients with oral mucositis during concurrent chemoradiotherapy of nasopharyngeal carcinoma and reduce the cost of treatment.