临床药师参与抗菌药物管理前后的临床应用情况调查分析

目的：分析对比我院临床药师参与抗菌药物临床应用管理前后的情况及存在问题。方法：采用随机抽样方法，回顾性调查我院临床药师参与管理前后抗菌药物使用情况，包括药物的使用品种、药品联用及不合理使用的主要差异等。结果：共调查400份出院病历，通过对比发现：临床药师参与管理前，头孢吡肟和头孢硫脒进入前十位；而参与管理后退出，头孢唑林进入前十位。联合用药方面：参与管理前为32.5%；参与管理后为22.0%。我院抗菌药物使用不合理的主要表现：喹诺酮类使用不当、抗菌药物选用档次较高、更换抗生素无依据、抗菌药物用药频次不当、围手术期用药时机不当、溶媒选择不当、联合用药无指征等。结论：我院临床药师参与抗菌药物管理后，在治疗及预防的合理应用方面取得了很大进步。

On the Participation of Clinical Pharmacists in the Management and Application of Antimicrobial Agents

Objective: To analyze the situation before and after the participation of clinical pharmacists in the clinical application and management of antibacterial drugs. Methods: Using random sampling method, retrospective survey was conducted to find the main differences before and after the involvement of clinical pharmacists in the application of antibacterial drugs, including drug varieties, combination usage and unreasonable usage. Results: A total of 400 patient records were investigated. Before clinical pharmacists were involved in the application of antibacterial drugs, cefepime and cephalosporin sulfur were among the top ten used drugs, whereas they fell out and cefazolin entered the list of top ten after participation of clinical pharmacists; the rate of combination usage dropped from 32.5% to 22.0% after participation of clinical pharmacists. The inappropriate usage of antibiotics drugs included:improper use of quinolones; selection of high-grade drugs; unreasonable switching of antibacterial drugs; unreasonable usage frequency of antibiotics, improper timing of drug usage in perioperative period; improper solvent selection and unreasonable combination usage. Conclusion: We have made great progress in the rational application of antibacterial drugs after participation of clinical pharmacists in the management of antibacterial drugs.