运用综合评价体系分析我院152例万古霉素临床应用

目的:评价我院万古霉素临床用药情况，促进合理用药。方法: 采用回顾性分析方法，汇总我院2013年1月至2013年7月住院患者开展万古霉素点评的病例共152份，参照《抗菌药物临床应用指导原则》 、2011《万古霉素临床应用中国专家共识》和美国MRSA指南，制定我院综合的评价体系进行用药分析。结果：152例应用万古霉素的病例中，有效病例141例（92.76%）；判断应用合理的有96例（63.16%），基本合理14例（9.21%），不合理42例（27.63%）；120例做了病原学检查和药敏实验，其中71例对万古霉素敏感；进行血药浓度监测的有77例（50.66%），共监测谷浓度283次；用药前后监测肾功能且判定为肾损伤的有16例。结论：我院万古霉素使用基本合理，但肾损害及输液浓度配置问题不容忽视，应加强监管，提高用药合理性。

Evaluation of 152 Clinical Cases Received Vancomycin Using Comprehensive System

Objective: To evaluate clinical cases using vancomycin in our hospital for promoting rational use of drug. Methods: A retrospective analysis summarized 152 hospitalized patients cases received vancomycin from January 2013 to July 2013 which referred to our own comprehensive evaluation system established from Guiding principles for clinical application of antibiotics, 2011 Expert Consensus and MRSA Guideline. Results: These were 141(92.76%) cases available among all 152 cases; including 96(63.16%) cases were judged entirely reasonable, 14(9.21%) cases were basically reasonable and 42(27.63%) cases were unreasonable; The amount of cases which were sensitive to vancomycin was 71 among 120 cases carried out pathogen and drug sensitivity test; 77 patients were monitored drug plasma concentration and obtained 283 data of Cmin ; 16 cases were identified renal injury after renal function tests around vancomycin administered. Conclusion: The applications of vancomycin in our hospital were basically reasonable, however the issue of renal injury and solution preparation should not be ignored, therefore supervision was supposed to be intensified for promoting rational use of drug.