基于层次属性模型的替考拉宁药物利用评价

目的 建立替考拉宁的药物利用评价（DUE）标准，采用属性层次模型（AHM）综合评价替考拉宁临床应用的合理性。方法 以替考拉宁药品说明书、相关临床指南与专家共识为依据，制订替考拉宁的DUE标准。采用AHM法对江苏省苏北人民医院2022年10月—2023年12月183例应用替考拉宁患者的病历进行分析。结果 替考拉宁不合理率居前3位的原因分别为给药剂量155例（84.70%）、不良反应124例（67.76%）、联合用药110例（60.11%）。病例得分（MRS）＜60的43例（23.50%），60≤MRS＜80的99例（54.10%），80≤MRS＜90的27例（14.75%），MRS≥90的14例（7.65%），病例平均得分为69.19分。结论 江苏省苏北人民医院替考拉宁临床使用合理性欠佳。给药剂量、不良反应及联合用药等方面有待完善，采取给药剂量优化、不良反应管理加强以及规范联合用药等措施进行针对性干预，进一步加强用药合理性监管，以提高替考拉宁的使用安全性和有效性。

Evaluation of teicoplanin drug utilization based on attribute hierarchical model

Objective To establish the DUE criteria for teicoplanin in patients infected objectively, and evaluate the rationality of clinical practice of teicoplanin based on AHM comprehensively. Methods The DUE criteria of teicoplanin were established based on the drug instructions, related clinical guidelines and expert consensus. The archived cases of 183 patients treated with teicoplanin for injection in the hospital from October 2022 to December 2023 were analyzed and evaluated by AHM. Results The top 3 reasons for the irrationality rate of teicoplanin were 155 cases (84.70%) of administered dose, 124 cases (67.76%) of adverse reactions, and 110 cases (60.11%) of co-medication. Through scoring the cases, MRS < 60 was 43 cases (23.50%), 60 ≤ MRS < 80 was 99 cases (54.10%), 80 ≤ MRS < 90 was 27 cases (14.75%), and ≥ 90 was 14 cases (7.65%), respectively. The average score was 69.19. Conclusion The rational use of teicoplanin in Northern Jiangsu People’s Hospital was not up to the mark. The rational clinical application of teicoplanin, including administration dosage, drug adverse reaction, combination of medication, remains to be improved. Targeted intervention measures such as administration dose optimization, adverse reaction management strengthening and combined drug use standardization should be taken to further strengthen the rational supervision of drug use, and effective measures needs to be taken to target intervention, so as to improve the safety and effectiveness of the use of teicoplanin.