摘要
目的:为临床合理选用抗菌药物眼用制剂提供参考。方法:汇总、分析某院2013年1月-2016年12月抗菌药物眼用制剂的使用情况,计算其用药频度(DDDs);收集细菌培养、鉴定及药敏试验结果,采用Pearson检验考察抗菌药物眼用制剂DDDs与细菌耐药率的相关性。结果:2013-2016年,该院使用的抗菌药物眼用制剂共计七大类10个品种,总DDDs呈上升趋势,年均增长率为26.16%。妥布霉素(地塞米松)滴眼液的DDDs连续3年(2013-2015年)最高,加替沙星滴眼液/眼用凝胶、氧氟沙星滴眼液/眼膏的DDDs在第2~4位波动。共送检眼部标本26 143份,检出细菌21种,共6 221株,检出率为23.80%。检出率最高的前3种细菌分别为表皮葡萄球菌(3 067株)、肺炎链球菌(470株)、金黄色葡萄球菌(321株)。上述3种细菌对红霉素的耐药率均在70%以上,而对利福平、氯霉素、庆大霉素、左氧氟沙星等药物较为敏感。利福平(2015年)、庆大霉素(2015、2016年)、四环素(2015年)、氧氟沙星(2014、2015年)、左氧氟沙星(2016年)、加替沙星(2016年)的平均耐药率与上一年比较,差异均有统计学意义(P<0.05)。四环素的DDDs与其平均耐药率呈正相关(r=1.000,P<0.05);而其他抗菌药物的DDDs与耐药率无关(P>0.05)。结论:该院患者眼部感染以表皮葡萄球菌、肺炎链球菌、金黄色葡萄球菌为主;四环素的DDDs与耐药率之间存在一定的相关性。规范抗菌药物眼用制剂的临床使用对延缓细菌耐药性的发展具有重要意义。
OBJECTIVE： To provide reference for suitable selection of antibacterial ophthalmic preparation in the clinic. METHODS： The application of antibacterial ophthalmic preparation in a hospital during Jan. 2013-Dec. 2016 were summarized and analyzed to calculate DDDs. The results of bacterial culture and identification, drug sensitivity test were collected. The correlation of DDDs of antibacterial ophthalmic preparation with resistance rates of bacteria was analyzed by using Pearson test. RESULTS： During 2013-2016, there were 7 categories of antibacterial ophthalmic preparations used in this hospital, involving 10 types. To- tal DDDs showed an upward trend with average annual growth rate of 26.16%. DDDs of Tobramycin （dexamethasone） eye drops were the highest for consecutive 3 years （2013-2015）. Gatifloxacin eye drops/eye gel and Ofloxacin eye drops/eye oint- ment ranged 2nd-4th place in the list of DDDs. A total of 26 143 ocular specimens were examined, and 21 kinds of bacteria were detected, involving 6 221 strains with detection rate of 23.80%. Top 3 bacteria in the list of detection rate were Staphylo- coccus epidermidis （3 067 strains）, Streptococcus pneumoniae （470 strains） and Staphylococcus aureus （321 strains）. Resistance rates of above 3 kinds of bacteria to erythromycin were all higher than 70%, while they were sensitive to rifampicin, chlorampheni- col, gentamicin and levofloxacin, etc. Compared to previous year, the average resistance rates of rifampicin （in 2015）, gentamicin （in 2015, 2016）, tetracycline （in 2015）, ofloxacin （in 2014, 2015）, levofloxacin （in 2016） and gatifloxacin （in 2016） had statisti- cally significant differences （P〈0.05）. DDDs of tetracycline was positively associated with its average resistance rate （r= 1.000,P〈 0.05）, and DDDs of other antibacterials had nothing to do with resistance rate （P〉0.05）. CONCLUSIONS： The main ocular infec- tions were S. epidermidis, S. pneumoniae and S. aureus. DDDs of tetracycline is certainly associated with resistant rates. Regulating clinical use of antibacterial ophthalmic preparation is important for delaying the development of bacterial resistance.
出处
《中国药房》
CAS
北大核心
2017年第26期3634-3638,共5页
China Pharmacy
基金
常州四药临床药学科研基金项目(No.CZSYJJ15013)
关键词
眼用制剂
抗菌药物
耐药性
用药频度
相关性
Ophthalmic preparation
Antibacterial agents
Drug resistance
Defined daily dose system
Correlation
