我院老年住院患者阿米卡星用药剖析.docVIP

我院老年住院患者阿米卡星用药剖析 　　[摘要] 目的 分析阿米卡星（AMK）在上海市嘉定区中心医院（以下简称“我院”）老年住院患者中的使用情况，促进临床合理用药。 方法 回顾性分析我院2015年1月～2016年12月使用AMK的老年住院患者的临床资料（诊断、微生物培养、肾功能、AMK给药方案、疗效及不良反应等），并进行统计分析。 结果 共有488例患者纳入分析，其中男288例，女200例，年龄65～92岁，平均（70.00±8.40）岁。以呼吸内科使用最多（43.65%），主要与β-内酰胺类药物合用（61.68%），针对革兰阴性菌感染（94.26%），总有效率为89.75%。AMK的药物利用度为0.53，最常用的给药方案为“0.4 g qd”（62.91%），共有7例患者治疗后血肌酐较前明显升高，可能有潜在的肾毒性风险。 结论 我院AMK使用剂量相对偏低，应在临床治疗过程中进行血药浓度监测，制订个体化给药方案，确保治疗安全有效。 　　[关键词] 阿米卡星；老年患者；用药 　　[中图分类号] R978.12 [文献标识码] A [文章编号] 1673-7210（2018）01（b）-0123-04 　　[Abstract] Objective To analyze the situations of Amikacin （AMK） applied in elderly inpatients in Jiading Central Hospital of Shanghai City （our hospital for short）， to promote rational drug use in the clinic. Methods The clinical data of elderly inpatients who used AMK in our hospital from January 2015 to December 2016 was analyzed retrospectively， which contained diagnosis， microbial culture， renal function， AMK dosage regimen， curative effect and adverse reactions， etc， then statistic analysis was made. Results Four hundred and eighty-eight patients （288 male， 200 female） were enrolled in the analysis， aged from 65 to 92 years old， with an average of （70.00±8.40） years old. AMK was used most commonly in Department of Respiratory Medicine （43.65%）. AMK was often used in combination with β-lactam antibiotics （61.68%） to against gram-negative bacterial infection （94.26%）， and the total effective rate was 89.75%. The drug utilization index of AMK was 0.53， and the most commonly prescribed drug regimen was 0.4 g qd （62.91%）. The levels of serum creatinine of 7 patients after treatment were significantly higher than those before treatment， which may had potential renal toxicity. Conclusion The dosage of AMK in our hospital is relatively low. It is necessary to take blood drug concentration monitoring in the course of clinical treatment and make individualized drug regimen， so as to make sure that the treatment is safe and effective. 　　[Key words] Amikacin； Elderly