摘要
目的:加强重症监护病房抗菌药物的使用和管理,探索临床药师参与临床合理使用抗菌药物的有效途径。方法:选取本院2012年4月至2013年3月重症监护病房(ICU)出院患者的病历143份作为干预前组,经"监测发现问题-干预-培训-计划"不断循环的方法干预后,选取2013年7月至2015年3月出院ICU患者病历147份作为干预后组,对干预前、后组用药合理性进行对比分析。结果:本院ICU患者抗菌药物的不合理使用率,干预前为38.5%,干预后降至7.48%;DDDs排序前15位的抗菌药物中药物利用指数(DUI)≤1的药物占比,干预前是33.33%,干预后升至60%;头孢美唑DDDs干预前为2 274,干预后降至1 157,使用频度明显降低;抗菌药物的使用以二联用药为主(干预前46.15%,干预后61.90%);干预采纳率为82.74%。结论:干预后ICU患者抗菌药物使用的合理性有所改善,说明临床药师参与ICU患者抗菌药物个体化给药方案的制定,在提高合理用药水平方面有效可行。
Objective ：To strengthen the application and management of antibiotics in intensive care unit（ ICU）,and explore the effective route of clinical pharmacist to participate in the rational clinical application of antibiotics. Methods ： The medical records of 143 patients in ICU of our hospital from April 2012 to March 2013 were selected and investigated by a cycle of ＂discovery of problems by monitoring-intervention-training-planning ＂,using those of 147 patients in ICU from July 2013 to March 2015 as control,to compare the rationality of clinical application of antibiotics before and after investigation. Results ： The irrational application rate of antibiotics in patients in ICU of our hospital decreased from 38.5% to 7.48% after investigation. However,the percentage of application of drugs with DUIs of not more than 1 and DDDs ranking top 15 increased from 33.33% to 60%. The DDDs of cefmetazole decreased significantly from 2 274 to 1 157. In most cases,two antibiotics were used in combination,the combination rates before and after investigation were 46.15% and 61.90% respectively. The adoption rate of intervention was 82.74%. Conclusion ： The rationality of application of antibiotics in patients in ICU was improved,indicating the feasibility of clinical pharmacists to participate in drawing up the individualized dosage regimen of patients in ICU to improving the level of rational drug use.
出处
《中国执业药师》
CAS
2015年第12期8-13,17,共7页
China Licensed Pharmacist
基金
2013年度梅州市科技计划项目医研
科教类(第一批)(2013B73)
