特殊使用级抗菌药物临床应用153例分析*

目的：分析特殊使用级抗菌药物临床使用情况，为合理用药提供依据。方法：回顾性收集2016年10月—2018年7月使用特殊使用级抗菌药物的患者153例，汇总一般资料、抗菌药物品种、用法用量、联用抗菌药物、微生物标本送检等资料，并对其使用合理性进行评价。结果：153例患者以男性居多，老年患者占比>50%，呼吸内科、血液内科、普外科用量大。比阿培南、美罗培南和替考拉宁使用频率高，分别占29.17%、20.83%、12.50%，用药频度分别为646.25、573.25、305.50。微生物送检率为61.47%，鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌是检出较多的菌株。联合用药占76.47%,其中二联用药占67.97%，三联用药占8.5%。联合用药不合理14例(9.15%)。结论：特殊使用级抗菌药物以碳青霉烯类使用量较大，联合用药频率高，微生物送检率较低，存在不合理使用现象，仍需加强管理。

Analysis of 153 cases of clinical application of antibiotics for special use*

Objective: To analyze the clinical use of antibiotics for special use and provide basis for rational drug use. Methods: A retrospective study was conducted on 153 patients who used antibiotics for special use from October 2016 to July 2017. The general data,varieties of antibiotics, usage and dosage, combined antibiotics, microbial samples and other data were collected, and the rationality of use was evaluated. Results: The majority of 153 patients were male and the proportion of elderly patients was more than 50%.The consumption of respiratory medicine, hematology medicine and general surgery was large.Biapenem, meropenem and teicoplanin were used more frequently, accounting for 29.17%, 20.83% and 12.50% respectively, and the frequencies were 646.25, 573.25 and 305.50 respectively. The microbial detection rate was 61.47%. Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa were the most detected strains. Most of the combined drugs(76.47%) were used, of which the combined use of two drugs accounted for 67.97%, and the combined use of three drugs accounted for 8.5%. 14 cases(9.15%) were unreasonable.Conclusion: Carbapenems were used in a large amount in antibiotics for special use, with high frequency of combined use, low rate of microbial detection, and unreasonable use. Therefore, management should be strengthened.