中国药物应用与监测
中國藥物應用與鑑測
중국약물응용여감측
CHINESE JOURNAL OF DRUG APPLICATION AND MONITORING
2013年
6期
323-324,325
,共3页
门诊处方%抗菌药物%处方点评%合理用药
門診處方%抗菌藥物%處方點評%閤理用藥
문진처방%항균약물%처방점평%합리용약
Outpatient prescriptions%Antibacterials%Analysis of prescriptions%Rational drug use
目的：依据抗菌药物PK/PD理论，对我院门诊药房抗菌药物不合理处方进行点评与分析，以期优化临床给药方案。方法：基于4例出现频数较高的不合理抗菌药物处方，结合抗菌药物PK/PD理论，明确药师在抗菌药物应用的适应证、用法用量、给药频次等问题的处方点评策略。结果：β-内酰胺类抗菌药物为时间依赖性抗菌药物，为取得较好临床疗效，β-内酰胺类抗菌药物的T > MIC需要超过给药间歇的40%；阿奇霉素片为大环内酯类抗菌药物，属于时间依赖性且PAE较长的抗菌药物，推荐给药频次为qd；氟喹诺酮类药物属于浓度依赖性抗菌药物，其有较高的组织浓度，AUC0-24 h/MIC ≥100和/或Cmax/MIC>8时可发挥良好的疗效。结论：在处方点评过程中，药师应评估患者的综合情况，以抗菌药物PK/PD理论为指导，开展有效地处方点评工作，对不合理处方积极干预，以促进临床合理用药。
目的：依據抗菌藥物PK/PD理論，對我院門診藥房抗菌藥物不閤理處方進行點評與分析，以期優化臨床給藥方案。方法：基于4例齣現頻數較高的不閤理抗菌藥物處方，結閤抗菌藥物PK/PD理論，明確藥師在抗菌藥物應用的適應證、用法用量、給藥頻次等問題的處方點評策略。結果：β-內酰胺類抗菌藥物為時間依賴性抗菌藥物，為取得較好臨床療效，β-內酰胺類抗菌藥物的T > MIC需要超過給藥間歇的40%；阿奇黴素片為大環內酯類抗菌藥物，屬于時間依賴性且PAE較長的抗菌藥物，推薦給藥頻次為qd；氟喹諾酮類藥物屬于濃度依賴性抗菌藥物，其有較高的組織濃度，AUC0-24 h/MIC ≥100和/或Cmax/MIC>8時可髮揮良好的療效。結論：在處方點評過程中，藥師應評估患者的綜閤情況，以抗菌藥物PK/PD理論為指導，開展有效地處方點評工作，對不閤理處方積極榦預，以促進臨床閤理用藥。
목적：의거항균약물PK/PD이론，대아원문진약방항균약물불합리처방진행점평여분석，이기우화림상급약방안。방법：기우4례출현빈수교고적불합리항균약물처방，결합항균약물PK/PD이론，명학약사재항균약물응용적괄응증、용법용량、급약빈차등문제적처방점평책략。결과：β-내선알류항균약물위시간의뢰성항균약물，위취득교호림상료효，β-내선알류항균약물적T > MIC수요초과급약간헐적40%；아기매소편위대배내지류항균약물，속우시간의뢰성차PAE교장적항균약물，추천급약빈차위qd；불규낙동류약물속우농도의뢰성항균약물，기유교고적조직농도，AUC0-24 h/MIC ≥100화/혹Cmax/MIC>8시가발휘량호적료효。결론：재처방점평과정중，약사응평고환자적종합정황，이항균약물PK/PD이론위지도，개전유효지처방점평공작，대불합리처방적겁간예，이촉진림상합리용약。
Objective:On the basis of PK/PD theory for antibacterials, the irrational prescriptions of antimicrobials were analyzed in the outpatient dispensary of our hospital in order to optimize clinical dosing regimens. Methods:Based on 4 cases of irrational antibacterial prescriptions with higher frequency, combined with PK/PD theory, the evaluating strategies were clariifed, such as the application of antibacterials indications, usage, dosage, drug frequency and so on. Results: β-lactam antibacterials were time-dependent antibacterials, T>MIC of which must be more than 40%interval time of administration for good antibacterial effect. Azithromycin tablet was macrolide antibacterials with time-dependent and long PAE, the dosing frequency of azithromycin was recommended as once a day. Fluoroquinolones were concentration-dependent antibacterials with higher tissue concentration, whose AUC0-24 h/MIC≥100 and/or Cmax/MIC>8 were necessary for good antibacterial effect. Conclusion:During the process of prescription analysis, pharmacists should evaluate the comprehensive conditions of patients, carry out effective prescription comment with the guidance of the PK/PD theory of antibacterials and actively provide effective intervention in order to promote clinical rational drug use.
