摘要
目的探究本院头孢菌素类抗菌药物合理使用及皮试情况。方法未下发《聊城市第三人民医院头孢菌素类抗菌药物皮肤试验管理规定》文件前,即2022年1月21日~5月20日收治的患者为对照组(1266例);下发《聊城市第三人民医院头孢菌素类抗菌药物皮肤试验管理规定》文件后,即2022年5月21日~9月20日为研究组(1579例)。统计药物包括头孢唑林、头孢呋辛、头孢曲松、头孢他啶、头孢唑肟、头孢噻肟、头孢哌酮舒巴坦的使用情况以及皮试情况。观察分析抗菌药物合理使用情况、两组每个月医院抗菌药物使用以及皮试情况、不同科室抗菌药物皮试情况以及未使用皮肤试验的安全性分析。结果观察组抗菌药物合理用药评分(85.45±3.47)分高于对照组的(72.45±2.74)分,差异有统计学意义(P<0.05)。2845例使用头孢菌素类抗菌药物患者中有1888例患者进行皮试,对照组2022年1月21日~2月20日、2月21日~3月20日、3月21日~4月20日、4月21日~5月20日的头孢菌素类抗菌药物使用人数分别为346、338、290、292例,进行皮试人数分别为334、324、270、271例,皮试率分别为96.53%、95.86%,93.10%,92.81%。研究组5月21日~6月20日、6月21日~7月20日、7月21日~8月20日、8月21日~9月20日头孢菌素类抗菌药物使用人数分别为256、472、455、396例,进行皮试人数分别为178、284、128、99例,皮试率分别为69.53%、60.17%,28.13%,25.00%,有明显降低趋势。头孢菌素类抗菌药物皮试在耳鼻喉科、重症加强护理病房(ICU)、消化内科、儿科较为遵守头孢菌素类抗菌药物皮肤试验,骨科以及普外科进展相对缓慢。未使用皮试的患者共957例,出现不良反应6例,未做皮试不良反应发生率6.27%(6/957),均为5岁以下儿童,头孢曲松出现3例四肢皮疹,1例腹痛;头孢呋辛出现1例发热;头孢唑肟钠出现1例头疼。结论规范头孢菌素类抗菌药物为抗菌药物安全合理应用的重要基础,需要积极加强并改进抗菌药物的皮试研究,确保抗菌药物使用安全性。
Objective To investigate the rational use and skin test of cephalosporins in our hospital.Methods Before the document"Administrative Provisions on the Skin Test of Cephalosporin Antibiotics in Liaocheng Third People's Hospital"was issued,the patients admitted from January 21 to May 20,2022 were selected as the control group(1266 cases);after the document of the"Administrative Provisions on the Skin Test of Cephalosporin Antibiotics in Liaocheng Third People's Hospital"was issued,the patients admitted from May 21 to September 20,2022 were selected as the study group(1579 cases).The use of cefazolin,cefuroxime,ceftriaxone,ceftazidime,ceftizoxime,cefotaxime,cefoperazone sulbactam and theiir skin test were collected.Observation and analysis of the rational use of antimicrobial drugs,the use of antimicrobial drugs in the hospital and the skin test situation in each month of the two groups,the skin test situation of antimicrobial drugs in different departments,and the safety analysis of cases without skin test.Results The score of rational use of antimicrobial drugs in the observation group was(85.45±3.47)points,which was higher than that of(72.45±2.74)points in the control group,and the difference was statistically significant(P<0.05).Skin tests were performed in 1888 of 2845 patients using cephalosporins.In the control group,the number of users of cephalosporins from January 21 to February 20,February 21 to March 20,March 21 to April 20,and April 21 to May 20,2022,were 346,338,290 and 292 cases,and the performed in skin tests were 334,324,270,and 271 cases,with skin test rates of 96.53%,95.86%,93.10%,and 92.81%.In the study group,the number of users of cephalosporins from May 21 to June 20,June 21 to July 20,July 21 to August 20,and August 21 to September 20 were 256,472,455 and 396 cases,and the skin tests were performed in 178,284,128 and 99 cases,with skin test rates of 69.53%,60.17%,28.13%and 25.00%,which showed a significant trend of decrease.Otolaryngology,intensive care unit(ICU),gastroenterology and pediatrics were more compliant with skin tests of cephalosporins,while orthopedics and general surgery showed relatively slow progress.A total of 957 patients did not use skin test,and 6 cases had adverse reactions,with an incidence of 6.27%(6/957),all of whom were children under the age of 5.3 cases of skin rash on the extremities and 1 case of abdominal pain occurred in ceftriaxone application;1 case of fever occurred in cefuroxime application;and 1 case of headache occurred in ceftizoxime sodium application.Conclusion The regulation of cephalosporins is an important basis for the safe and rational use of antimicrobial drugs,and it is necessary to actively strengthen and improve the skin test study of antimicrobial drugs to ensure their safety use.
作者
刘辉
张鲲
李卓民
LIU Hui;ZHANG Kun;LI Zhuomin(Liaocheng Third People's Hospital,Liaocheng 252000,China)
出处
《中国实用医药》
2023年第24期143-146,共4页
China Practical Medicine
