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目的:调查评价某院万古霉素临床使用情况,为促进万古霉素的合理应用提供参考。方法:采用回顾性研究方法,调查某院2015年9月~2016年2月使用万古霉素的100例住院患者病历资料,对药品的使用情况、病原学检查及血药浓度监测等情况进行统计汇总,并根据按有关指南制定的“万古霉素应用合理性评价标准”进行用药合理性评估,对用药不合理情况进行分类统计分析。结果:100例使用万古霉素住院患者,男性61%,女性39%,平均年龄(55.69±19.88)岁;治疗有效率为81%;发生不良反应1例(1%);药物利用指数DUI为0.66;微生物标本送检率为69.4%,根据药敏结果选用万古霉素23例;进行血药浓度监测15例(占15%),对其中6例血药浓度>20μg·ml~(-1)者进行剂量调整;给药方案基本合理,但有疗程不合理者11例;不合理使用万古霉素20例(占20%)。结论:该院万古霉素使用基本合理,不存在过度使用现象。但仍存在某些不适宜用药问题。
Objective: To investigate and evaluate the clinical use of vancomycin in a hospital and provide references for the rational application of vancomycin. Methods: A retrospective study was conducted to investigate the medical records of 100 hospitalized patients who used vancomycin from September 2015 to February 2016 in a hospital. The data were collected on the use of drugs, the etiological examination and the monitoring of plasma concentrations Summary, and according to the guidelines developed by the “Evaluation of the application of rationality of vancomycin ” rationality assessment of drug use cases of unreasonable classification and statistical analysis. Results: 100 hospitalized patients with vancomycin were 61% males and 39% females, with an average age of 55.69 ± 19.88 years; the effective rate was 81%; adverse reactions occurred in 1 case (1%); the drug use index (DUI) 0.66; The rate of delivery of microbiological specimens was 69.4%. According to the results of drug susceptibility, vancomycin was selected in 23 cases. Blood concentration was monitored in 15 cases (15%), of which 6 cases of plasma concentration was> 20μg · ml ~ (-1) ) Dose adjustment; dosing program is reasonable, but there are 11 cases of irrational treatment; unreasonable use of vancomycin in 20 cases (20%). Conclusion: The use of vancomycin in this hospital is basically reasonable and there is no overuse. However, there are still some problems with inappropriate medication.