【摘要】：目的:為促進萬古霉素的臨床合理使用提供參考。方法:參照萬古霉素藥品說明書、《抗菌藥物臨床應用指導原則(2015年版)》和《萬古霉素臨床應用中國專家共識(2011版)》等,抽取我院2013年1月-2014年12月共720份使用萬古霉素的住院患者病歷,就其用藥情況進行回顧性分析。結果:720例患者中男性(428例)多于女性(292例),以41~65歲患者居多(45.83%);預防用藥50例(6.94%),治療用藥670例(93.06%),患者分布于36個科室;720例患者中19例給藥劑量2 g/d,發(fā)生不良反應的有13例(1.81%);670例治療用藥病例中微生物檢驗樣本送檢587例(87.61%),且有522例(77.91%)聯(lián)合使用了其他抗菌藥物;549例≥18歲的治療用藥病例萬古霉素藥物利用指數(shù)(DUI)=0.96;用藥不適宜病例共240例(33.33%),其中溶媒使用不適宜192例(26.67%),用法用量不適宜28例(3.89%),聯(lián)合用藥不適宜20例(2.78%)。結論:我院萬古霉素總體應用基本合理,使用科室分布較廣,聯(lián)合用藥現(xiàn)象較為普遍,微生物檢驗樣本送檢率合格,不存在濫用現(xiàn)象,但其臨床使用過程中仍存在某些不適宜情況。應加強萬古霉素合理使用的專項點評與培訓,進一步規(guī)范萬古霉素的用藥監(jiān)護,以保障患者的用藥安全。
[Abstract]:Objective: to provide reference for the rational use of vancomycin in clinic. Methods: according to the vancomycin drug specification, the guidelines for clinical application of antimicrobial agents (2015) and the consensus of Chinese experts on the clinical application of vancomycin (2011), etc. From January 2013 to December 2014, 720 medical records of inpatients with vancomycin were collected and analyzed retrospectively. Results: among 720 patients, 428 cases were male (428 cases) more than 292 female (45.83%), 50 cases (6.94%) were prophylaxis, 670 cases (93.06%) were treated with prophylaxis and 670 cases (93.06%), the patients were distributed in 36 departments. Of the 720 patients, 19 were given 2 g / d, 13 (1.81%) had adverse reactions. Of the 670 cases, 587 (87.61%) were examined by microbiological examination, and 522 (77.91%) were treated with other antimicrobial agents. The vancomycin utilization index (DUI) was 0.96 in 549 patients aged more than 18 years. 240 cases (33.33%) were not suitable for drug use, among which 192 cases (26.67%) were not suitable for solvent use, 28 cases (3.89%) were not suitable for use of solvent, and 20 cases (2.78%) were not suitable for combined use. Conclusion: the general application of vancomycin in our hospital is reasonable, the use of vancomycin is widely distributed in departments, the phenomenon of combined use of drugs is relatively common, the rate of microbiological examination samples is qualified, and there is no phenomenon of abuse. However, there are still some inappropriate conditions in clinical use. Special comments and training on the rational use of vancomycin should be strengthened so as to further standardize the monitoring of vancomycin use in order to ensure the safety of patients in the use of vancomycin.
【作者單位】： 吉林大學第一醫(yī)院藥學部
【分類號】：R978

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