临床药师干预对促进呼吸内科抗菌药物合理使用的临床意义研究

目的观察临床药师干预对呼吸内科抗菌药物合理使用的促进作用。方法从2013年6月起临床药师对本院呼吸内科抗菌药物使用进行干预,收集临床药师干预前后在本院就诊的呼吸内科病例资料各240例,作为非干预组和干预组。比较两组患者间使用率居前10位的抗菌药物使用率、联合用药率和病原学检测率及不合理用药的发生率。结果干预前后排名前10位的抗菌药物发生了变化,与干预前相比头孢哌酮/舒巴坦、注射用阿莫西林/克拉维酸、哌拉西林/他唑巴坦、注射用头孢呋辛和左氧氟沙星注射液的使用率均显示下降,注射用阿奇霉素使用率上升（P〈0.05）,此外头孢替安替代莫西沙星注射液进入前10位。干预后抗菌药物使用率、联合用药率及不合理用药的发生率均显著下降,而病原学检测率则大大提高（P〈0.05）。结论临床药师干预能有效纠正呼吸内科抗菌药物的不合理使用情况,降低抗菌药物使用率。

Clinical significance research of clinical pharmacist intervention in rational application of antibacterial agents in department of respiratory medicine

Objective To observe the promoting effects of clinical pharmacist intervention in rational application of antibacterial agents in department of respiratory medicine.Methods The clinical pharmacists in our hospital made an intervention on the antibiotics application in department of respiratory medicine from June 2013. A total of 240 cases in department of respiratory medicine before and after intervention were collected as the non-intervention group and the intervention group. Comparisons were made on the usage rate of top 10 antibacterial agents, drug combination rate, etiological detection rate, and incidence of irrational drug use between the two groups.Results There were difference between the top 10 used antibiotics in the two groups. The usage rates of cefoperazone/sulbactam, amoxicillin/clavulanic acid, piperacillin/cefuroxime, cefuroxime and levofloxacin injection after intervention appeared to decline, while the rate of azithromycin injection increased （〈0.05）. Moreover, cefotiam ranked in the top 10, taking place of moxifloxacin injection. The usage rate of antibacterial agents, drug combination rate, and incidence of irrational drug use were all significantly decreased after intervention, while the etiological detection rate remarkably increased （P〈0.05）.Conclusion The intervention made by clinical pharmacist can correct the irrational application of antibacterial agents in department of respiratory medicine, and reduce the usage rate of antibacterial agents.