重型病毒性肝炎死亡患者抗生素应用分析

目的为了解重型病毒性肝炎死亡患者抗生素的使用率及使用的合理性,加强抗生素的应用管理。方法采用回顾性调查方法,对1999年1月至2002年12月出院的118例重型病毒性肝炎死亡患者进行调查。结果118例患者中抗生素应用率95.7%,治疗用药68.3%(院外感染60.2%,院内感染29.8%),预防用药31.7%。总体上合理用药75.6%,不合理用药24.4%;标本送检率32.8%,细菌培养阳性率9.7%,按药敏应用抗生素6.9%。抗生素应用不合理种类:用药时间过长占37.8%,同类抗生素重复应用占27.3%;抗生素应用种类太多,联合3种抗生素占29.7%;无抗生素应用指征且未记录用药目的占26.9%。抗生素治疗有效率45.7%,继发真菌感染14例(12.4%)。结论临床抗生素应用仍然存在许多不合理的现象,有必要进一步加强抗生素的合理应用管理。

An analysis on antibiotic use in the dead cases of severe viral hepatitis

Objective To probe into the use rate and rationality of antibiotic drugs in the dead cases of severe viral hepatitis,so as to enhance the use control of this kind of drugs.Methods A retrospective survey was made on 118 dead cases of severe viral hepatitis who had been discharged from hospital from Jan 1999 to Dec 2002.Results Antibiotic use rate was 95.7% in the 118 cases,of the percentile 68.3% belonged to therapeutic use (nonhospital infectoin 60.2%,and hospital infection 29.8%),and 31.7% belonged to preventive use;all in all,75.6%could be regarded as rational use ,but 24.4% as irrational use;specimen-detected rate was 32.8%,with a bacteria-positive rate 9.7%;drug use according to the sensitization tests accounted for 6.9%.The irrational uses included:a too long-term use of antibiotics accounted for 37.8%;repeated use of the same kind of antibiotics accounted for 27.3%;combined use of too many kinds of antibiotics,such as three antibiotics′co-use (29.7%);some cases without clear indication to any antibiotics or even without any records for medication aim (26.9%).The effective curative rate was 45.7%,while secondary fungus infection occurred in 14 cases (12.4%).Conclusion Lots of irrational uses of antibiotic drugs remained in clinics,there must be enhanced a control for the antibiotic use.