某院碳青霉烯类抗菌药物的临床应用调查与用药合理性评估

摘要

OBJECTIVE:To explore the clinical utilization of carbapenems in a hospital,analyze and evaluate its medication rationality. METHODS:All the 508 medical records of inpatients treated with carbapenems from Jul. 2012 to Jun. 2015 were retro-spectively investigated,the utilization and pathogenic examination of carbapenems were evaluated;by setting the carbapenems eval-uating standard,the medication rationality of carbapenems was evaluated and inappropriate cases were classified and analyzed statis-tically. RESULTS:The drug utilization indexed (DUI) of Imipenem and cilastatin sodium for injection and Meropenem for injec-tion were 0.80 and 1.32,respectively;the total rate of microbial inspection was 95.9%;according to the drug sensitive test result, the rate of drug selection was 62.8%;there were 54 cases(10.6%)of irrational use records,in which,irrational dosage(42.6%) and improper drug selection (31.4%) were the major problems. CONCLUSIONS:There are some inappropriate medication prob-lems in carbapenems utilization in the hospital. Developing the carbapenems utilization evaluation is helpful to discover typical medi-cation problems,which can provide reference for intervention and continuous improvement of rational drug use.%目的：了解某院碳青霉烯类抗菌药物的临床应用情况，分析和评价其用药合理性。方法：回顾性调查该院2012年7月－2015年6月期间使用碳青霉烯类抗菌药物的全部住院患者508例，对药品使用及病原学检查情况进行分析评价，并根据制定的碳青霉烯类抗菌药物临床应用合理性评估标准进行用药合理性评估，对不适宜问题进行分类整理。结果：该院注射用亚胺培南西司他丁钠及注射用美罗培南的药物利用指数分别为0.80和1.32；总的微生物送检率为95.9％；按药敏试验结果选择用药率为62.8％；用药不适宜病历共54份，占全部抽取病历的10.6％，其中用法用量不适宜（42.6％）和药物选择不适宜（31.4％）为主要问题。结论：该院碳青霉烯类抗菌药物在临床使用中存在不适宜问题。开展碳青霉烯类抗菌药物临床应用评估工作有助于发现典型问题，为合理用药干预及持续改进提供参考。