我院2013－2015年慢性阻塞性肺疾病急性加重期抗菌药物利用评价

摘要

OBJECTIVE:To evaluate the effectiveness,safety and economics of antibiotics for inpatients with acute exacerba-tion of chronic obstructive pulmonary diseases (AECOPD),in order to promote rational use of antibiotics. METHODS:In retro-spective study,AECOPD inpatients were selected as research objects during 2013-2015 to evaluate the use of antibiotics. RE-SULTS:Three thousand one hundred and eighty-six AECOPD patients were enrolled in the study,and utilization ratio of antibiot-ics was above 90%. DDDs of Cefordizime sodium for injection ranked the first place in 3 years and was decreased in 2015,while those of β-lactam and carbapenems were increased. DDC of Meropenem for injection and Imipenem/cilastatin sodium for injection were the highest. Drug utilization index(DUI)of Cefodizime for injection was far more than 1.0,while DUI of Piperacillin sodi-um and sulbactam sodium for injection was much less than 1.0. Sort ratio(B/A)of Cefodizime sodium for injection ranged 1-2 in 3 years. B/A of Piperacillin sodium and sulbactam sodium for injection,Imipenem and cilastatin sodium for injection,Meropenem for injection were lower than 1.0. CONCLUSIONS:The indication of anti-infective treatment in AECOPD patients have been mas-tered strictly in our hospital;the utilization ratio of antibiotics is decreased year by year;the types of antibiotics are rational rela-tively,and the number of antibiotics which is rationally used is increased year by year. But the rationality of Cefodizime sodium for injection and Piperacillin sodium/sulbactam sodium for injection need to be improved.%目的：评价慢性阻塞性肺疾病急性加重期（AECOPD）住院患者使用抗菌药物的有效性、安全性和经济性，以促进抗菌药物的合理使用。方法：采用回顾性研究方法，以2013－2015年度为评价时间段，以主要诊断为AECOPD的住院患者为研究对象，评价其抗菌药物利用情况。结果：纳入本研究的AECOPD患者共3186人次，抗菌药物使用率在90％以上。注射用头孢地嗪钠的用药频度（DDDs）在3年中连续排在第1位，但在2015年有所下降；而含酶的β-内酰胺类和碳青霉烯类抗菌药物的DDDs有所上升。日均费用（DDC）以注射用美罗培南和注射用亚胺培南西司他丁钠最高。药物利用指数（DUI）远大于1.0的有注射用头孢地嗪钠，远小于1.0的有注射用哌拉西林钠舒巴坦钠。注射用头孢地嗪钠的排序比（B/A）在3年中都介于1～2之间，注射用哌拉西林钠舒巴坦钠、注射用亚胺培南西司他丁钠、注射用美罗培南的B/A都小于1.0。结论：我院AECOPD患者的抗感染治疗适应证掌握较为严格，抗菌药物使用率在逐年下降，抗菌药物的品种选择较为合理，药物利用基本合理的抗菌药物数量在逐年增加，但注射用头孢地嗪钠、注射用哌拉西林钠舒巴坦钠的药物利用合理性还有待提高。