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目的:调查与分析我院获得性感染(HAI)患者的抗菌药临床应用状况与应用合理性。方法:对2007年我院发生的328例HAI病历进行回顾性调查;对328例HAI患者使用抗菌药的种类、使用频率、更换频率、疗程、费用金额、给药途径、联合用药、静脉给药时间、治疗结果、细菌培养和药敏试验、不合理用药等进行统计分析。结果:HAI类型出现例次最多是呼吸道感染(51.52%);抗菌药使用频率前5位的是:头孢菌素类、青霉素类、喹诺酮类、林可霉素与克林霉素类、大环内酯类;抗菌药以静脉给药(90.66%)治疗途径为主,静脉给药时间平均(5.05±3.92)d;住院总费用与抗菌药费用比为10.69:1;联合用药以二联(32.31%)为主;HAI抗菌药治疗有效率达80.79%;不合理用药以用药间隔时间不当(42.34%)为主。结论:医院药事委员会及感染管理委员会应适时依据《指导原则》、《医院感染管理规范》及本院实际情况制定HAI抗菌药治疗的标准操作规程(SOP),减少因临床处方者决策困难而频繁更换抗菌药品种或多种联用的现象,使HAI抗菌药物的应用更加合理规范。
Objective: To investigate and analyze the clinical application and rational use of antibacterials in patients with acquired infection (HAI) in our hospital. Methods: A retrospective survey of 328 cases of HAI in our hospital in 2007 was conducted. The types, frequency of use, frequency of replacement, duration of treatment, cost, route of administration, combination therapy, intravenous administration Time, treatment results, bacterial culture and susceptibility testing, irrational use of drugs such as statistical analysis. Results: The highest incidence of HAI type was respiratory tract infection (51.52%). The top five frequencies of antimicrobial agents were cephalosporins, penicillins, quinolones, lincomycin and clindamycins, macrocycles (90.66%) were treated by antibiotics, the average time of intravenous administration was (5.05 ± 3.92) d, the cost ratio of hospitalization to antibacterial was 10.69: 1, 32.31%). The effective rate of HAI antimicrobial treatment was 80.79%. Irrational medication was mainly based on improper medication interval (42.34%). Conclusion: The hospital pharmacy committee and Infection Control Committee should formulate the standard operation rules (SOP) of antimicrobial treatment of HAI in time according to Guiding Principles, NOS and the actual conditions in our hospital to reduce the difficulty of decision making by clinical prescribers Frequent replacement of antibacterial species or a combination of multiple phenomena, so that the application of HAI antibacterial drugs more reasonable specification.