【摘要】：目的:從橫斷面角度了解某院注射用左氧氟沙星的臨床應(yīng)用情況,為加強(qiáng)左氧氟沙星的臨床應(yīng)用管理和優(yōu)化給藥方案提供依據(jù)。方法:采用連續(xù)多點(diǎn)橫斷面法對某院2014年8月至2015年3月每月13日注射用左氧氟沙星的使用情況進(jìn)行統(tǒng)計(jì)和分析,結(jié)合濃度依賴性抗菌藥物PK/PD理論、左氧氟沙星特點(diǎn)和抗菌藥物臨床應(yīng)用指導(dǎo)原則,分別從用藥目的、用藥劑量、感染部位和聯(lián)合用藥等方面評判其用藥合理性。結(jié)果:一日一次給藥方案為224例(43.41%),一日兩次給藥方案為292例(56.59%);日劑量0.6 g為251例(48.64%),日劑量0.4 g為78例(15.12%),日劑量0.3 g為162例(31.40%),日劑量0.2 g為25例(4.84%);患者肌酐清除率在20~49 mL·min-1區(qū)間的藥物利用指數(shù)為1.61,肌酐清除率在10~19 mL·min-1區(qū)間的藥物利用指數(shù)為1.67,大于65歲老年患者藥物利用指數(shù)為1.56;無適應(yīng)證用藥73例(14.15%),其中非手術(shù)無適應(yīng)證用藥17例(3.29%);手術(shù)預(yù)防用藥56例(10.85%);未考慮患者年齡、腎功能和感染部位,給藥劑量過高39例(7.56%),給藥劑量過低69例(13.37%);中樞神經(jīng)系統(tǒng)感染用藥17例(3.29%);同類藥物聯(lián)合用藥10例(1.94%),無指征三/四聯(lián)用藥31例(6.01%)。210例患者用藥存在問題,總的不合理使用率40.70%。結(jié)論:左氧氟沙星PK/PD理論適用于其臨床應(yīng)用評價(jià),判斷其臨床應(yīng)用的合理性還需綜合考慮患者腎功能、感染部位和手術(shù)部位。
[Abstract]:Objective: to understand the clinical application of levofloxacin for injection in a hospital from a cross-sectional point of view, and to provide the basis for strengthening the clinical application management of levofloxacin and optimizing the regimen of administration of levofloxacin. Methods: the use of levofloxacin for injection in a hospital from August 2014 to March 13, 2015 was statistically analyzed by continuous multi-point cross-sectional method, combined with the PK/PD theory of concentration-dependent antimicrobial agents. The characteristics of levofloxacin and the guiding principles of clinical application of antimicrobial agents were evaluated in terms of the purpose, dosage, site of infection and combination of antibiotics. Results: 224 cases (43.41%) were treated once a day and 292 cases (56.59%) were administered twice a day. The daily dose of 0.6 g was 251 cases (48.64%), the daily dose of 0.4 g was 78 cases (15.12%), the daily dose of 0.3 g was 162 cases (31.40%), the daily dose of 0.2 g was 25 cases (4.84%). The drug utilization index of patients with creatinine clearance in the range of 20 ~ 49 mL min-1 was 1.61.The drug utilization index of patients with creatinine clearance at 1019 mL min-1 was 1.67, which was higher than that of the aged patients aged 65 years. There were 73 cases (14.15%) without indications, 17 cases (3.29%) with non-operative indications, 56 cases (10.85%) with surgical prophylaxis. 39 cases (7.56%) were overdosed, 69 cases (13.37%) were given too low dose, 17 cases (3.29%) were treated with central nervous system infection. There were 10 cases (1.94%) with the same drug combination and 31 cases (6.01%) with no indication of combined use of three or four drugs. 210 patients had problems with the use of drugs, and the total irrational utilization rate was 40.70%. Conclusion: levofloxacin PK/PD theory can be used to evaluate the clinical application of levofloxacin. It is necessary to consider the renal function, site of infection and site of operation in order to judge the rationality of the clinical application of levofloxacin.
【作者單位】： 蚌埠醫(yī)學(xué)院第一附屬醫(yī)院藥劑科;蚌埠醫(yī)學(xué)院第一附屬醫(yī)院呼吸與危重癥醫(yī)學(xué)科;
【基金】：安徽省教育廳2014年度高等教育振興計(jì)劃人才項(xiàng)目[皖教秘人(2014)181號(hào)] 安徽省教育廳2016年度高校領(lǐng)軍人才引進(jìn)與培育計(jì)劃項(xiàng)目[皖教秘人(2015)211號(hào)]
【分類號(hào)】：R978.1

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