我院icu抗菌药物的使用与细菌耐药的相关分析.docVIP

抗菌药物用量与细菌耐药性的相关性分析 李荣 袁灵 邓小利 蒋英蓝 曾敬怀 郑捍东 四川省泸州市人民医院 摘要 目的 探讨抗菌药物用量与细菌耐药性之间的关系，为控制感染提供依据。方法 对2008~2010年常用抗菌药物的使用频率及常见细菌耐药性进行分析。结果 三年以来常用抗菌药物的DDDs由6042上升到8111，增长了34.24%，其中头孢哌酮他唑巴坦、头孢呋辛和头孢西丁用量增长明显。致病菌以革兰氏阴性菌为主，在11种常用抗菌药物中，氨苄西林舒巴坦对四种病原菌的耐药率均比较高；哌拉西林钠他唑巴坦钠、头孢哌酮他唑巴坦和亚胺培南西司他丁的敏感率较高，阿莫西林克拉维酸钾对非产ESBLs的大肠埃希菌较敏感，鲍曼不动杆菌对其他药物的耐药率较高。结论 细菌耐药性与抗菌药物的使用频度增加存在一定相关性，应加强细菌耐药性监测与合理用药指导。 关键词 抗菌药物；DDD值；DDDs；耐药性； Antibacterial drug dosage and correlation analysis of bacterial drug resistance Li, Yuan Ling Deng Xiaoli Jiang Ying blue, who worship Zheng Han east 646000 while luzhou, sichuan province peoples hospital Objective to investigate the antibacterial drug dosage and the relationship between the bacterial drug resistance, provide the basis for infection control. Methods from 2008 to 2010 commonly used antimicrobial drug use frequency and common bacteria resistance were analyzed. Results three years commonly used the DDDs of antibiotics from 6042 to 8111, increased by 34.24%, with cefoperazone he azole temple, cefuroxime, and amount of cefoxitin growth significantly. Pathogenic bacteria is given priority to with gram-negative bacteria, in 11 kinds of commonly used antimicrobial agents, ampicillin shu ba jotham, have higher percentages of four kinds of pathogenic bacteria; Piperacillin sodium thiazole ba jotham, cefoperazone sodium he thiazole ba and imide sensitive rate is higher, south west division of his ding, amoxicillin clavulanic acid potassium for producing ESBLs of e. coli is sensitive, acinetobacter baumannii for higher percentages of other drugs. Conclusion bacteria resistance and antibacterial drug use frequency increases, there is a certain correlation of bacterial drug resistance surveillance should be strengthened and the guidance of rational drug use. Key words of antimicrobial agents; DDD value; DDDs. Drug resistance; 近年来，随着抗菌药物在临床的大量使用，其耐药性日趋严重，从而形成恶性循环，细菌性感染患者的治疗日趋困难，因而有必要对常用的抗菌药的使用量与细菌耐药性的关系进行分析。 1.材料与方法 2.结果 2.2 细菌分布：2008～2010年临床分离菌株株，排名前几位的常见革兰阴性菌分别为肺炎克雷伯菌、铜