依据抗菌药物PK-PD理论对我院门诊药房抗菌药物不合理处方的点评及案例解析.pdfVIP

中国药物应用与监测 2013 年12月第10卷第6 期 Chinese Journal of Drug Application and Monitoring, Vol.10, No.6, December 2013 依据抗菌药物PK/PD 理论对我院门诊药房抗菌药物不合理处方的点评及 案例解析 谢婷婷，朱　曼，任浩洋（解放军总医院药品保障中心，北京100853 ） [摘要]　目的：依据抗菌药物PK/PD 理论，对我院门诊药房抗菌药物不合理处方进行点评与分析，以期优化临床给药方案。 方法：基于4 例出现频数较高的不合理抗菌药物处方，结合抗菌药物PK/PD 理论，明确药师在抗菌药物应用的适应证、用法 β - β 用量、给药频次等问题的处方点评策略。结果： 内酰胺类抗菌药物为时间依赖性抗菌药物，为取得较好临床疗效，- 内酰 胺类抗菌药物的T MIC 需要超过给药间歇的40% ；阿奇霉素片为大环内酯类抗菌药物，属于时间依赖性且PAE 较长的抗 菌药物，推荐给药频次为qd ；氟喹诺酮类药物属于浓度依赖性抗菌药物，其有较高的组织浓度，AUC0-24 h/MIC ≥ 100 和/ 或 C /MIC 8 时可发挥良好的疗效。结论：在处方点评过程中，药师应评估患者的综合情况，以抗菌药物PK/PD 理论为指导， max 开展有效地处方点评工作，对不合理处方积极干预，以促进临床合理用药。 [关键词]　门诊处方；抗菌药物；处方点评；合理用药 [ 中图分类号]　R969.3 [ 文献标识码]　A　 [ 文章编号]　1672 – 8157(2013)06 – 0323 – 03 　 　 Analysis of irrational antibacterials prescriptions based on the PK/PD theory of antibacterial drugs in the outpatient dispensary of our hospital XIE Ting-ting, ZHU Man, REN Hao-yang(Department of Pharmaceutical Care, PLA General Hospital, Beijing 100853, China) [ABSTRACT]　Objective: On the basis of PK/PD theory for antibacterials, the irrational prescriptions of antimicrobials were analyzed in the outpatient dispensary of our hospital in order to optimize clinical dosing regimens. Methods: Based on 4 cases of irrational antibacterial prescriptions with higher frequency, combined with PK/PD theory, the evaluating strategies were clarified, such as the application of antibacterials indications, usage, dosage, drug frequency and so on. Results: β -lactam antibacterials were time-dependent antibacterials, T MIC of which must be more than 40% interval time of administration for good antibacterial effect. Azithromycin tablet was macrolide antibacterials with time-dependent and long PAE, the dosing frequency of azithromycin was recommended as once a day. Fluoroquinolones were concentration-dependent anti