【摘要】：目的:評(píng)價(jià)慢性阻塞性肺疾病急性加重期(AECOPD)住院患者使用抗菌藥物的有效性、安全性和經(jīng)濟(jì)性,以促進(jìn)抗菌藥物的合理使用。方法:采用回顧性研究方法,以2013-2015年度為評(píng)價(jià)時(shí)間段,以主要診斷為AECOPD的住院患者為研究對(duì)象,評(píng)價(jià)其抗菌藥物利用情況。結(jié)果:納入本研究的AECOPD患者共3 186人次,抗菌藥物使用率在90%以上。注射用頭孢地嗪鈉的用藥頻度(DDDs)在3年中連續(xù)排在第1位,但在2015年有所下降;而含酶的β-內(nèi)酰胺類和碳青霉烯類抗菌藥物的DDDs有所上升。日均費(fèi)用(DDC)以注射用美羅培南和注射用亞胺培南西司他丁鈉最高。藥物利用指數(shù)(DUI)遠(yuǎn)大于1.0的有注射用頭孢地嗪鈉,遠(yuǎn)小于1.0的有注射用哌拉西林鈉舒巴坦鈉。注射用頭孢地嗪鈉的排序比(B/A)在3年中都介于1~2之間,注射用哌拉西林鈉舒巴坦鈉、注射用亞胺培南西司他丁鈉、注射用美羅培南的B/A都小于1.0。結(jié)論:我院AECOPD患者的抗感染治療適應(yīng)證掌握較為嚴(yán)格,抗菌藥物使用率在逐年下降,抗菌藥物的品種選擇較為合理,藥物利用基本合理的抗菌藥物數(shù)量在逐年增加,但注射用頭孢地嗪鈉、注射用哌拉西林鈉舒巴坦鈉的藥物利用合理性還有待提高。
[Abstract]:Objective: to evaluate the efficacy, safety and economy of using antibiotics in (AECOPD) patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) in order to promote the rational use of antimicrobial agents. Methods: retrospective study was used to evaluate the use of antimicrobial agents in patients with AECOPD in 2013-2015. Results: a total of 3 186 AECOPD patients were included in this study, and the antimicrobial use rate was over 90%. The frequency of cefdiazine sodium for injection was ranked first in three years, but decreased in 2015, while the DDDs of 尾 -lactam and carbapenem antibiotics with enzyme increased. The daily average cost (DDC) of meropenem for injection and imipenem sodium for injection were the highest. The drug utilization index (DUI) was far greater than 1. 0 for cefdiazine sodium for injection, and for piperacillin sodium for injection and sulbactam sodium for injection. The sequence ratio (B / A) of cefdiazine sodium for injection (B / A) was between 1 and 2 in 3 years, piperacillin sodium for injection and sulbactam sodium for injection, imipenem for injection and meropenem for injection were all less than 1.0. Conclusion: the indications of anti-infective therapy for AECOPD patients in our hospital are strict, the utilization rate of antimicrobial agents is decreasing year by year, the variety selection of antimicrobial agents is more reasonable, and the number of antimicrobial agents whose use is basically reasonable is increasing year by year. However, the rationality of cefdiazine sodium for injection and piperacillin sodium for injection for sulbactam still needs to be improved.
【作者單位】： 南方醫(yī)科大學(xué)附屬小欖醫(yī)院藥劑科;
【基金】：中山市科技計(jì)劃項(xiàng)目社會(huì)發(fā)展攻關(guān)計(jì)劃(醫(yī)療)(No.2015B1237)
【分類號(hào)】：R563.9

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