69例使用万古霉素类药物患者的病例调查分析.pdfVIP

中国药物应用与监测2011年8月第8卷第4期 Chinese Journal of Drug Application and Monitoring, Vol.8, No.4, August 2011 ·不良反应调查 · 69例使用万古霉素类药物患者的病例调查分析 廖晓玲，何秋香，梁蕴贤 （解放军42 1 医院，广东 广州 510318 ） [摘要] 目的：了解万古霉素类药物的使用情况。方法：对2009 年本院69 例使用万古霉素类的住院患者，就其用药的指征、 用法、病原学检查及处方医师资格等方面进行调查分析。结果：不合理用药表现为：适应证过宽，82.61% 的病例没有明确的 用药指征，包括未做细菌培养、培养结果阴性或为革兰阴性菌；疗程过长或过短（最长22 d ，最短1 d ）；79.4 1% 的手术病例术 后给药预防感染；联合用药比例高达95.66% ，最多6 种联用，且随意性大，更换频繁；72.86% 的处方医师不具备开具特殊使 用类抗菌药物的资格。结论：应进一步加强抗菌药物的使用管理，加大对临床用药监护的人力、物力投入。 [关键词] 万古霉素；去甲万古霉素；抗菌药物；合理用药 [ 中图分类号] R978.1 [文献标识码] A [文章编号] 1672 – 8157(2011)04 – 0224 – 05 Survey and analysis on 69 cases of patients using vancomycins LIAO Xiao-ling, HE Qiu-xiang, LIANG Yun-xian ( NO. 421 Hospital of PLA, Guangzhou 510318, China ) [ABSTRACT] Objective: To investigate the application of vancomycins. Methods: A total of 69 inpatients used vancomycins in 2009 in our hosptial were investigated and analyzed in respect of the indications of medication, usage, examination of etiology and qualifications of doctors. Results: There were several types of irrational use of drugs. Indications of medication were too wide, 82.61% of all the cases were treated without clear indications, such as no result of bacterial culture, negative cultivation results or gram-negative bacterium. The course of treatments were too long or too short (the longest course was 22 days and the shortest was 1 day). 79.4 1% of surgical cases used antibacterials for prophylaxis after operation. The proportion of combination use of antibacterials was as high as 95.66%, and up to 6 kinds of drugs were used at the same time, the selection and change of antibacterials were very optional and frequent. 72.86% of the prescribers had no qualification of prescribing antibiotics for special use. Conclusion: Regulation of antibacterials should be further improved, more manpower and material inputs on clinical medication monitoring need