亚胺培南西司他丁临床使用药物利用评价分析

摘要

Objective To evaluate normative rationality of clinical use of imiPenem and aPPly guidelines for its rational clinical use with DUE mode. Methods We made imiPenem clinical use DUE standard according to Ministry of Health The national clinical application of antibacterial drugs special rectification activities of 2012,Methods clinical application of anti-bacterial drug of 2012,Guidelines for clinical use of antibacterial of 2011,and Imipenem instructions and relevant documents. And we also did retrosPective analysis,statistics and summary about the management of antimicrobial agents,the indications of drug use,drug use and treatment outcome of 196 Patients who received imiPenem in one hosPital on the basis of DUE Standard. Results ①Management entry:Microbial insPection rate was 70. 4%(80%);the coincidence rate of PrescriPtion Privileges was 91. 3%(100%);②The indications of drug use:suitable rate was 85. 2%(90%);③Medication Process:the correct rate of the administration route,solvent selection and incomPatibility were 100%( 100%);About the driPPing time could not been evaluated for no doctor order indication;and effect of monitoring comPliance rate was 52. 0%( 85%),and there were four old Patients with renal injury who had not received dose titration;④Medication effective rate was 73%(80%). Conclusion There was certain disParity between clinical use of imiPenem and some of exPected numerical value in this hosPital,which could do some intervention and rectification for existing Problems to ensure the rational use of antimi-crobial drugs sPecification. Imipenem clinical use DUE standard had certain effect to Promote the rational use of imiPenem in clinical.%目的：利用DUE模式，评价亚胺培南临床使用规范性、合理性，为临床规范合理使用提供参考。方法依据卫生部《2012年全国抗菌药物临床应用专项整治活动方案》、卫生部2012年《抗菌药物临床应用管理办法》、2011年《抗菌药物临床应用指导原则》、亚胺培南使用说明、有关文献等，制定“亚胺培南临床使用DUE标准”。并依据该标准对某医院2013年住院患者使用亚胺培南196例次病历进行抗菌药物管理、用药指征、用药过程、治疗结果4个方面进行回顾性分析、统计、总结。结果①管理项：微生物送检率70.4%（80%）；处方权限符合率91.3%（100%）；②用药指征：适合率85.2%（90%）；③用药过程：给药途径、溶媒选择、配伍禁忌正确率100%（100%）；滴注时间医嘱未注明无法评价；疗效监测项符合率52.0%（85%）；老人及肾功能损伤4例未进行剂量调整。④用药结果有效率73%（80%）。结论某医院亚胺培南临床使用与多项预期目标值存在一定差距。医院应针对存在问题进行干预和整改，确保抗菌药物的规范合理使用。认为“亚胺培南临床使用DUE标准”对临床规范、合理使用亚胺培南有一定促进作用。