目的 探讨血培养结果在指导临床合理使用药物中的价值.方法 对江苏省徐州市儿童医院4个科室的100份血培养阳性患儿的病历资料进行回顾性分析.结果 经验性治疗占到了98%,而培养前用药与最终检验细菌所适宜的抗菌药物的吻合度为90.8%,但是经验用药与最终药敏培养结果的符合度只有51.6%;一级报告发出后,临床医生在调整抗菌药物方面增加与替换的各占20%左右,有60%左右的抗菌药物未作调整;二级报告发出后,有大约5%的患儿增加了抗菌药物,替换抗菌药物的比例达到了32%,同时减少抗菌药物的比例也占到了3%;三级报告发出后,抗菌药物的使用与最终药敏结果的一致性达到了83%,不一致的仅有5%左右.结论 该院临床儿科医生对血培养三级报告的结果还是非常倚重的,执行抗菌药物由经验治疗到目标治疗的力度也是非常积极的.%Objective To investigate the value of blood culture result in guiding clinical rational use of drugs in clinic.Methods The medical records of 100 children patients with blood culture positive in the four departments of our hospital were retrospectively analyzed.Results The empirical treatment accounted for 98%,the goodness of fit in the medication before culture with the appropriate antibacterial drugs according to final detected bacteria was only 51.6%;after issuing the level 1 report,the adding and substituting drugs in adjusting the antibacterial drugs accounted for about 20% each,60% of antibacterial drugs were not adjusted;after issuing the level 2 report,about 5% of children patients added the antibacterial drugs,the proportion for replacing antibacterial drugs reached 32%,meanwhile the proportion for reducing accounted for 3%;after issuing the level 3 report,the consistency of antibacterial drugs use with the final drug susceptibility test results reached 83%,the inconsistency was only about 5%.Conclusion Clinical pediatric doctors in this hospital still heavily rely on the results of blood culture 3 levels reports,executing antibacterial agents from the experience treatment to the target treatment is also very active.
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