克林霉素注射剂临床应用的合理性与安全性评价

目的 了解克林霉素注射剂临床应用的合理性及安全性,为克林霉素注射剂临床合理应用与管理提供参考.方法 采用回顾性调查方法,抽取某三甲医院2009年全年使用克林霉素注射剂的住院患者病历；参考药品说明书、卫生部有关规定和指导原则等,制定克林霉素注射剂临床使用的合理性评价标准；评价克林霉素注射剂临床应用的合理性与安全性.结果 共纳入有效病例260例,其中预防用药219例,占84.2％；治疗用药41例,占15.8％；符合适应证标准有256例,占98.5％；符合用法用量标准有182例,占70.0％；符合药物禁忌证标准有243例,占93.5％；符合药物相互作用标准有257例,占 98.9％,克林霉素注射剂临床使用合理性的综合判断结果为用药合理有65例,占 25.0％；基本合理有84例,占32.3％；不合理用药有111例,占42.7％；260例使用克林霉素注射剂后病历中记载发生有药品不良反应的有8例,占3.1％.结论 某院克林霉素注射剂的临床应用仍存在不合理现象,有待加强合理应用知识的宣传培训,不断规范医师用药行为,只有正确掌握用药适应证,把握正确剂量、疗程和用法,加强用药监控,才能确保克林霉素注射剂临床使用的安全、有效.

Evaluation of clinical rationality and safety of clindamycin injection

OBJECTIVE To understand the condition of the rationality and safety of clindamycin injection and provide reference for the reasonable clinical application of clindamycin injection.METHODS Retrospective review on the patients who have used clindamycin injection by cluster sampling in 2009 in a 3A grade hospital was carried out,the reasonable evaluation criteria of clinical use of clindamycin injection was developed and the rationality and safety of clindamycin injection were evaluated.RESULTS A total of 260 cases were involved,including 219 prophylaxis cases(84.2%) and 41 treatment cases(15.8%);totally 256 cases had antibiotics by using the indications,accounting for 98.5%;182 cases had standard dosing,accounting for 70.0%;243 cases had no contraindications,accounting for 93.5%;257 cases had no drug-drug interactions,accounting for 98.9%.After the evaluation of the comprehensive rationality of all cases,65 cases were rational(25.0%);84 cases were basically rational(32.3%),111 cases were irrational(42.7%);among the medical records of 260 cases undergoing clindamycin injection,the adverse reactions occurred in 8 cases,accounting for 3.1%,significantly higher the that of foreign counties.CONCLUSION There is unreasonable use of clindamycin injection in the hospital.In order to ensure the safety and rationality of clindamycin injection,the doctors should understand the medication indication and grasp the correct dose,course and usage.