我院2013-2014年万古霉素临床应用分析.PDF

我院2013－2014年万古霉素临床应用分析 ＊ # 谢 慧 ，姜顺军，陈文瑛，肖翔林，喻鹏久（广州医科大学附属第一医院药学部，广州 510120） 中图分类号 R978.1；R969.3 文献标志码 A 文章编号 1001-0408（2015）20-2756-04 DOI 10.6039/j.issn. 1001-0408.2015.20.07 摘 要 目的：为进一步制定万古霉素合理使用规范提供依据。方法：回顾性分析我院2013年6月－2014年12月经静脉使用万 古霉素的正常出院患者的相关信息。结果：178例使用万古霉素的患者，平均年龄59.6岁，男性占73.60％，以肺部感染为主 （74.72％）。用药前辅助检查充分，66.29％属经验性治疗用药，病原学送检率达85.39％。71.91％的患者行治疗药物监测，但首次 监测血药浓度仅47.66％处于目标范围。结论：万古霉素在我院使用较为合理，但需关注经验性用药疗程、治疗药物监测的合理性 以及个体化初始剂量等问题。 关键词 万古霉素；处方分析；治疗药物监测；合理用药 Analysis of Clinical Application of Vancomycin in Our Hospital from 2013to 2014 XIE Hui ，JIANG Shun-jun ，CHEN Wen-ying ，XIAO Xiang-lin ，YU Peng-jiu （Dept. of Pharmacy ，the First Affiliat- ed Hospital of Guangzhou Medical University ，Guangzhou 510120，China ） ABSTRACT OBJECTIVE ：To provide reference for further formulation of the rational use of vancomycin. METHODS ：Retro- spective analysis was conducted on the related information of discharged patients who intravenously used vancomycin from Jun. 2013 to Dec. 2014. RESULTS ：178patients were enrolled ，with average age of 59.6 and 73.60％male ，who were mainly with lung infectious （74.72％）. Support examinations were sufficient before using of vancomycin. 66.29％patients were empirically giv- en vancomycin with pathogenic detection rate of 85.39％. 71.91％patients were conducted therapeutic drug monitoring with only 47.54％of first blood samples achieved the target range. CONCLUSIONS ：Vancomycin application is generally rational in our hos- pital. However ，issues like duration of empirical therapy ，rational therapeutic monitoring ，and individualized start dosing still need to be noticed. KEYWORDS Vancomycin ；Prescription analysis ；Therapeutic drug monitoring ；Rational drug application 万古霉素是首个糖肽类抗菌药物，其通过抑制细菌细胞 份。收集患者基本资料，包括姓名、病历号、年龄、性别、