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目的调查医院感染患者的抗菌药物使用情况,为临床合理使用抗菌药物提供参考依据。方法回顾性调查123例医院感染患者的临床资料,统计分析抗菌药物的使用情况。结果 123例住院感染患者中送检采样标本65例,送检率为52.85%;感染部位以上呼吸道、下呼吸道和泌尿道为主,分别占35.77%、30.90%、17.07%;共培养出病原菌65株,前3位病原菌依次为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌,分别占35.39%、27.69%、13.85%;使用抗菌药物时间最长的12d,平均为4~6d,平均使用抗菌药物≥2种,其中用药频次最高的第二代头孢菌素占39.83%,其次为第一代和第三代头孢菌素,分别占29.27%和17.07%,应用较少的为氨基糖苷类和喹诺酮类,仅占4.07%,抗菌药物单联使用率占50.41%,联合应用比率占49.59%。结论医院感染患者使用抗菌药物品种选择档次高、联合用药多、用药指征不明确、经验性用药问题多、使用时间长,需加大专项培训和整治力度,强化规范性用药。
Objective To investigate the use of antimicrobial agents in patients with nosocomial infections and provide reference for the rational use of antimicrobial agents in clinic. Methods The clinical data of 123 hospitalized patients were retrospectively analyzed. The use of antibacterials was statistically analyzed. Results Among the 123 inpatients with infection in hospital, 65 samples were sent for sampling, the rate of which was 52.85%. The upper respiratory tract, lower respiratory tract and urinary tract were the main infection sites, accounting for 35.77%, 30.90% and 17.07% respectively. The first three pathogens were Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus, accounting for 35.39%, 27.69% and 13.85%, respectively. The longest antimicrobial time was 12 days with an average of 4-6 days, The average use of antimicrobial drugs ≥ 2 species, of which the highest frequency of use of second-generation cephalosporins accounted for 39.83%, followed by the first and third generation cephalosporins, accounting for 29.27% and 17.07%, less used amino Glycosides and quinolones, accounting for only 4.07%, antibacterials single use accounted for 50.41%, combined application rate of 49.59%. Conclusions Patients with nosocomial infections have a high selection of antibacterials, high levels of combination medication, unclear indications of medication, many problems of empirical medication and long time of use. Special training and remediation efforts are needed to strengthen the normative medication.