抗菌药物预防性应用失败与病原体耐药性探讨

目的:为临床合理预防性应用抗菌药物提供参考。方法:对我院2006～2007年抗菌药物预防性应用失败病例进行监测,分析预防性用药失败原因,并对此期间临床送检标本进行病原微生物培养、分离、鉴定及细菌药敏试验,对结果进行耐药性分析。结果:头孢菌素类、喹诺酮类、青霉素类、头孢菌素类+酶抑制剂是我院临床预防性使用较多的抗菌药物,耐药率分别为57.21%、65.14%、68.63%、18.81%;监测病例240例,预防性应用抗菌药物877频次,其中388频次为无指征用药,占44.24%;耐药459频次,占52.34%;药物选择不恰当286频次,占32.61%;发生二重感染42例,发生率17.50%。结论:临床预防性使用抗菌药物存在较多问题,亟待加强规范化管理。

Failure in the Prophylactic Use of Antibiotics and Antibiotic Resistance of Pathogens

OBJECTIVE:To provide reference for the rational clinical prophylactic use of antibiotics. METHODS:The cases in whom the clinical prophylactic use of antibiotics between 2006 and 2007 in our hospital showed failure in efficacy were monitored to analyze the cause of failure,meanwhile the clinical samples were sent for culture,isolation,identification and drug susceptibility tests as well as drug resistance analysis. RESULTS:Cephalosporins,Quinolones,Penicillins,Cefhalosporins enzyme inhibitor were more commonly used antibiotics in our hospital,with drug resistance rates at 57.21%,65.14%,68.63%,and 18.81% respectively. Among the total 240 cases monitored,the prophylactic use of antibiotics totaled 877 times,of which,388 (44.24%) were non-indicated drug use,459 (52.34%) showed drug resistance,286 (32.61%) involved improper drug choice,and 42 (17.50%) showed dual infection. CONCLUSION:The clinical prophylactic use of antibiotics in our hospital is far from perfect; therefore,it is urgent to tighten control on the standard prophylactic use of antibiotics.