老年心力衰竭合并肺部感染患者抗感染药物的应用分析

目的 调查分析医院老年心力衰竭合并肺部感染患者的抗感染药物应用情况,评估其临床使用的合理性,为临床合理用药提供参考.方法 回顾性调查分析2005年1月-2010年12月老年心力衰竭合并肺部感染患者的抗感染药物临床使用情况.结果 2005-2007年前3位抗感染药物的分别为头孢菌素类、喹诺酮类和青霉素类,其中头孢菌素类在这3年的销售金额居于首位,分别为5.81、6.59、6.76万元；2008-2010年碳青霉烯类和硝基咪唑类药物的用量呈明显上升趋势,尤其是碳青霉烯类由2005年第5位升至2010年第2位；在2005-2010年喹诺酮类药物DDDs值均居于前3位,而美罗培南、替硝唑针的DDDs分别上升至第1、2位;2005-2010年抗感染药物的用量符合率与适应证均呈逐年升高趋势,用量符合率由64.52％升至96.55％,适应证符合率由80.65％升至96.55％.结论 医院对老年心力衰竭合并肺部感染患者的抗感染药物应用基本合理,但仍存在个别过量使用情况,应进一步加强管理,促进抗感染药物的合理使用.

Application of anti-infective antibiotics in senile patients combined with heart failure and pulmonary infections

OBJECTIVE To investigate and analyze the application of anti-infective antibiotics for pulmonary infection in senile patients with heart failure and assess its clinical rationality,so as to provide reference for reasonable use of antibiotics.METHODS From Jan.2005 to Dec.2010,the clinical application of anti-infective antibiotics for patients with heart failure and pulmonary infections were retrospectively analyzed.RESULTS The top 3 anti-infective antibiotics applied from 2005 to 2007 were cephalosporins,quinolones,and penicillins.The sale amounts of cephalosporins ranked the first during those three years,which were 58100,65900,and 67600 yuan.The dosing of carbapenems and nitroimidazoles showed a rising trend of consumption,especially carbapenems,rising from the fifth in 2005 to the second in 2010.During the period from 2005 to 2010,the DDDs of quinolones ranked in the top three,and the DDDs of meropenem and tinidazole rose to the first and second;from 2005 to 2010,the compliance rate of anti-infective antibiotic application as well as the indications showed an increasing tendency annually;the compliance rate of the amount increased from 64.52% to 96.55%,the compliance rate of the indications increased from 80.65% to 96.55%.CONCLUSION The use of anti-infective antibiotics for senile patients with heart failure combined with pulmonary infections is basically reasonable,but there still exists problems of excessive dosing,so it is necessary to strengthen the management to promote the rational use of anti-infective antibiotics.