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目的:从横断面角度了解某院注射用左氧氟沙星的临床应用情况,为加强左氧氟沙星的临床应用管理和优化给药方案提供依据。方法:采用连续多点横断面法对某院2014年8月至2015年3月每月13日注射用左氧氟沙星的使用情况进行统计和分析,结合浓度依赖性抗菌药物PK/PD理论、左氧氟沙星特点和抗菌药物临床应用指导原则,分别从用药目的、用药剂量、感染部位和联合用药等方面评判其用药合理性。结果:一日一次给药方案为224例(43.41%),一日两次给药方案为292例(56.59%);日剂量0.6 g为251例(48.64%),日剂量0.4 g为78例(15.12%),日剂量0.3 g为162例(31.40%),日剂量0.2 g为25例(4.84%);患者肌酐清除率在20~49 mL·min-1区间的药物利用指数为1.61,肌酐清除率在10~19 mL·min-1区间的药物利用指数为1.67,大于65岁老年患者药物利用指数为1.56;无适应证用药73例(14.15%),其中非手术无适应证用药17例(3.29%);手术预防用药56例(10.85%);未考虑患者年龄、肾功能和感染部位,给药剂量过高39例(7.56%),给药剂量过低69例(13.37%);中枢神经系统感染用药17例(3.29%);同类药物联合用药10例(1.94%),无指征三/四联用药31例(6.01%)。210例患者用药存在问题,总的不合理使用率40.70%。结论:左氧氟沙星PK/PD理论适用于其临床应用评价,判断其临床应用的合理性还需综合考虑患者肾功能、感染部位和手术部位。
OBJECTIVE: To understand the clinical application of levofloxacin for injection in a hospital from the cross-sectional perspective, and to provide a basis for strengthening the clinical management and optimizing the administration of levofloxacin. Methods: The continuous multi-point cross-sectional method was used to analyze and analyze the usage of levofloxacin for injection in a hospital from August 2014 to March 2015 on the 13th of each month. Combined with the PK / PD theory of concentration-dependent antibiotics and the characteristics of levofloxacin Antibiotics clinical guidelines for the application, respectively, from the purpose of the drug, the dose, the site of infection and the combination of drug use and other aspects of evaluation of its rationality. RESULTS: The daily dosage regimen was 224 (43.41%) and the dosage regimen was 292 (56.59%) twice daily. The daily dosage of 0.6 g was 251 (48.64%) and the daily dosage of 0.4 g was 78 (15.12%). The daily dose of 0.3g was 162 cases (31.40%) and the daily dose of 0.2g was 25 cases (4.84%). The drug utilization index of patients with creatinine clearance ranged from 20 to 49 mL · min-1 was 1.61, The creatinine clearance index ranged from 1.67 in the range of 10-19 mL · min-1, and 1.56 in elderly patients older than 65. There were 73 cases (14.15%) with no indications, of which non-surgical indications were 17 (3.29%). Fifty-six cases (10.85%) were treated with prophylactic prophylaxis. Thirty-nine patients (7.56%) were overdosed and 69 patients (13.37%) underdosed without considering the patient’s age, ; 17 cases (3.29%) were treated with CNS infection; 10 cases (1.94%) were treated with similar drugs, and 31 cases (6.01%) with no indication of triple / quadruple drug use. 210 patients with medication problems, the total unreasonable use rate of 40.70%. Conclusions: PK / PD theory of levofloxacin is suitable for clinical evaluation. To determine the rationality of its clinical application, renal function, infection site and surgical site should be considered.