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目的比较北京市8家医疗单位使用氧氟沙星和左氧氟沙星ADR发生情况及其影响因素,以及临床应用的合理性和安全性,并进行经济学评价。方法采用前瞻性和回顾性调查方法。按统一表格填写调查内容,按统一标准进行统一数据处理。结果①ADR的发生率氧氟沙星为8.4％,左氧氟沙星为3.2％,均以轻中度为主,消化道反应及皮肤反应多见。②总的用药合理性为基本合理>合理>不合理。不合理用药比例氧氟沙星组为21.5％,左氧氟沙星组为20.3％。③用于手术预防和治疗感染,在同等疗效下左氧氟沙星组的成本高于氧氟沙星组;预防用药不合理所致的抗菌药物的费用增加是显著的。结论:①本项研究中,氧氟沙星和左氧氟沙星ADR的发生率与国内外基本一致。左氧氟沙星组ADR的发生率小于氧氟沙星组,临床应用安全性较好。②本项研究中,左氧氟沙星和氧氟沙星的使用基本合理;手术预防用药和老年人群中不合理用药比例较高。③由于不合理用药等因素影响,使左氧氟沙星组的成本高于氧氟沙星组,存在明显的经济学不合理性。
Objective To compare the incidence and influential factors of ofloxacin and levofloxacin in eight medical units in Beijing, as well as the rationality and safety of clinical application and carry out economic evaluation. Methods Using prospective and retrospective survey methods. According to the unified form to fill in the survey content, according to unified standards for unified data processing. Results ① The incidence of ADR was ofloxacin 8.4% and levofloxacin 3.2%, both of which were mild to moderate, gastrointestinal reactions and skin reactions were common. ② The rationality of the total medication as the basic reasonable> reasonable> unreasonable. Irrational drug use ratio ofloxacin group was 21.5%, levofloxacin group was 20.3%. ③ For surgical prevention and treatment of infections, the cost of levofloxacin group is higher than that of ofloxacin group under the same effect; the cost of antimicrobial drug caused by prevention of unreasonable use is significant. Conclusion: ① In this study, the incidence of ofloxacin and levofloxacin ADR basically the same as at home and abroad. The incidence of ADR in levofloxacin group was less than that of ofloxacin group, and the safety of clinical application was better. ② In this study, the use of levofloxacin and ofloxacin was basically reasonable; the prophylactic use of surgery and the irrational use of drugs in the elderly population were higher. ③ due to irrational use of drugs and other factors, the cost of levofloxacin group is higher than the ofloxacin group, there is a clear economic irrationality.