【摘要】：目的探討多糖肽類抗生素在住院患者中的臨床應(yīng)用情況,評(píng)價(jià)其用藥合理性,為臨床合理用藥提供參考依據(jù)。方法采用回顧性調(diào)查方法調(diào)查某院2014年1—12月使用多糖肽類抗生素的住院患者,記錄其相關(guān)臨床資料。結(jié)果共納入病例727例,其中感染患者471例(占64.79%)。社區(qū)感染與醫(yī)院感染均以呼吸道為主(分別占39.17%、45.98%)。多糖肽類抗生素用藥天數(shù)平均6.06 d(4 403/727)。重癥監(jiān)護(hù)病房(ICU)、腫瘤科及神經(jīng)外科患者使用例數(shù)最多,分別為148例(20.36%)、88例(12.10%)、81例(11.14%)。單用糖肽類患者338例(46.49%),聯(lián)用種類平均達(dá)4.43種,三聯(lián)及以上達(dá)99例(13.62%),聯(lián)用頻率最高的為第二代頭孢菌素類(20.48%)。多糖肽類抗生素中使用萬古霉素450例(61.90%),使用替考拉寧260例(35.76%),萬古霉素與替考拉寧同用17例(2.34%)。共分離病原體847株,主要為鮑曼不動(dòng)桿菌(111株,13.10%)、肺炎克雷伯菌(80株,9.45%)、銅綠假單胞菌(68株,8.03%)及金黃色葡萄球菌(54株,6.37%),其中耐甲氧西林金黃色葡萄球菌50株。經(jīng)多糖肽類抗生素治療后有效490例,有效率為67.40%。727例患者中,用藥合理86例(11.83%),基本合理315例(43.33%),不合理326例(44.84%)。結(jié)論該院多糖肽類抗生素使用情況基本合理,但對(duì)適應(yīng)證的把握有待加強(qiáng)。
[Abstract]:Objective to investigate the clinical application of polyglycopeptide antibiotics in inpatients and to evaluate the rationality of the use of polyglycopeptide antibiotics. Methods A retrospective survey was conducted to investigate the clinical data of patients who used polyglycopeptide antibiotics in a hospital from January to December 2014. Results A total of 727 cases were included, of which 471 cases (64.79%) were infected. Respiratory tract was the main infection in community and hospital (39.17% and 45.98% respectively). The average duration of administration of polyglycopeptide antibiotics was 6.06 days (4403 / 727). (ICU), oncology and neurosurgery were the most frequently used cases in intensive care unit, which were 148 cases (20.36%), 88 cases (12.10%) and 81 cases (11.14%) respectively. 338 cases (46.49%) were treated with glycopeptide alone, with an average of 4.43 kinds of combined use, 99 cases (13.62%) of triple use and above, and the second generation cephalosporins (20.48%). Among the polyglycopeptide antibiotics, 450 cases (61.90%) were treated with vancomycin, 260 cases (35.76%) with teicoplanin, 17 cases (2.34%) with both vancomycin and teicoplanin. A total of 847 strains of pathogens were isolated, including Acinetobacter baumannii (111, 13.10%), Klebsiella pneumoniae (80, 9.45%), Pseudomonas aeruginosa (68, 8.03%) and Staphylococcus aureus (54, 6.37%). Among them, 50 strains of methicillin-resistant Staphylococcus aureus were isolated. In 490 patients treated with polyglycopeptide antibiotics, the effective rate was 67.40.727 cases, 86 cases (11.83%) were reasonable, 315 cases (43.33%) were reasonable, 326 cases (44.84%) were unreasonable. Conclusion the use of polyglycopeptide antibiotics in our hospital is basically reasonable, but the indication needs to be strengthened.
【作者單位】： 第三軍醫(yī)大學(xué)大坪醫(yī)院野戰(zhàn)外科研究所重慶市感染控制中心;
【分類號(hào)】：R95

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