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[摘要]
目的 了解黃石市婦幼保健院住院患者感染耐甲氧西林金黃色葡萄球菌(MRSA)的用藥情況。方法 選取2015-2017年該院院內(nèi)感染MRSA的住院病歷410份,對(duì)標(biāo)本來(lái)源、抗菌藥名稱、用法用量、療程、聯(lián)合用藥及特殊級(jí)抗菌藥物臨床應(yīng)用管理等進(jìn)行調(diào)查,計(jì)算抗菌藥物用藥頻度(DDDs)和藥物利用度指數(shù)(DUI),并對(duì)不適宜用藥進(jìn)行總結(jié)。結(jié)果 410株MRSA標(biāo)本主要來(lái)自于痰液(51.46%)、膿性分泌物(22.44%)和血液(12.44%)。410份病歷中,共涉及6種抗菌藥,其中替考拉寧使用最多(32.81%),其次為萬(wàn)古霉素(25.79%)和利奈唑胺(23.08%);替考拉寧的DDDs最大(1 512.35),其次為利奈唑胺(922.83)和萬(wàn)古霉素(907.20),所有藥物的DUI ≤ 1.0;用藥不適宜病歷57份(13.90%),主要為用法用量不適宜(25份,43.86%)和溶媒不適宜(16份,28.07%);所有特殊級(jí)抗菌藥物均未越級(jí)使用,但只有38份(9.27%)經(jīng)專家會(huì)診后使用。結(jié)論 萬(wàn)古霉素、替考拉寧和利奈唑胺是該院治療MRSA感染的主要藥物,且臨床使用較好,不存在濫用傾向,但也有必要進(jìn)一步規(guī)范合理用藥,延緩細(xì)菌耐藥。
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[Abstract]
Objective To investigate the antibacterial utilization of methicillin resistant Staphylococcus Aureus (MRSA) infection in Huangshi Maternal and Child Health Care Hospital.Methods A total of 410 inpatients who infected MRSA in Huangshi Maternal and Child Health Care Hospital from 2015 to 2017 were selected. The sources of the specimens, antibiotics name, usage and dosage, medication course, drug combination, and clinical application management of special antibacterial drugs were investigated. The defined daily dose system (DDDs) and drug utilization index (DUI), were calculated, and summarized and the inappropriate use of drugs.were analyzedResults A total of 410 specimens of MRSA mainly came from sputum (51.46%), purulent discharge (22.44%), and blood (12.44%). Six kinds of antimicrobial agents were involved in the 410 cases, and the maximum usage was teicoplanin (32.81%), followed by vancomycin (25.79%) and linezolid (23.08%), the maximum of DDDs was teicoplanin (1512.35), followed by linezolid (922.83) and vancomycin (907.20), DUI of all drugs were ≤ 1.0. The 57 cases (13.90%) were inappropriate used, in which inappropriate usage and dosage (25 cases, 43.86%) and inappropriate solvent (16 cases, 28.07%) were the main types. All special grade antibacterial drugs were not leapfrog used, but only 38 cases (9.27%) were used after consultation by experts.Conclusion Vancomycin, teicoplanin, and linezolid are the mainstreams of treatment MRSA infection in Huangshi Maternal and Child Health Care Hospital, and the clinical use is better, and no tendency to abuse.But it is necessary to further standardize rational use of drugs and delay the pace of bacterial resistance.
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