CAJ | 학술논문

目的：分析静脉用药配置中心参与特殊使用抗菌药物会诊对抗菌药物用量及细菌耐药性的影响，为促进临床合理用药积累经验。方法回顾性分析静脉用药配置中心参与会诊前(2014年1~6月)、会诊后(2014年7~12月)的特殊使用抗菌药物月平均销售金额及用药频度(DDDs)，同时采用细菌药物敏感性试验比较会诊前后主要病原菌对特殊使用抗菌药物的耐药。结果静脉用药配置中心参与会诊后，除亚胺培南外，其余特殊使用抗菌药物的月平均销售金额及DDDs与会诊前比较均显著降低(P<0.05)，其中头孢吡肟、头孢匹罗、万古霉素、利奈唑烷减少最为明显。静脉用药配置中心参与会诊后，大肠埃希菌、铜绿假单胞菌对除伊曲康唑、伏立康唑以外的特殊使用抗菌药物耐药率与会诊前比较显著降低(P<0.05)，鲍曼不动杆菌对美罗培南、亚胺培南耐药率与会诊前比较显著升高(P<0.05)，肺炎克雷伯菌对美罗培南、亚胺培南、利奈唑烷、替拉考宁与会诊前比较显著降低(P<0.05)。结论通过对静脉药物配置中心参与会诊，能够保证特殊使用抗菌药物的合理利用，延缓细菌耐药性，为临床用药的合理性和科学性提供保障。
목적：분석정맥용약배치중심삼여특수사용항균약물회진대항균약물용량급세균내약성적영향，위촉진림상합리용약적루경험。방법회고성분석정맥용약배치중심삼여회진전(2014년1~6월)、회진후(2014년7~12월)적특수사용항균약물월평균소수금액급용약빈도(DDDs)，동시채용세균약물민감성시험비교회진전후주요병원균대특수사용항균약물적내약。결과정맥용약배치중심삼여회진후，제아알배남외，기여특수사용항균약물적월평균소수금액급DDDs여회진전비교균현저강저(P<0.05)，기중두포필우、두포필라、만고매소、리내서완감소최위명현。정맥용약배치중심삼여회진후，대장애희균、동록가단포균대제이곡강서、복립강서이외적특수사용항균약물내약솔여회진전비교현저강저(P<0.05)，포만불동간균대미라배남、아알배남내약솔여회진전비교현저승고(P<0.05)，폐염극뢰백균대미라배남、아알배남、리내서완、체랍고저여회진전비교현저강저(P<0.05)。결론통과대정맥약물배치중심삼여회진，능구보증특수사용항균약물적합리이용，연완세균내약성，위림상용약적합이성화과학성제공보장。
Objective To analyze the effect of intravenous drug allocation center participating in the consultation of us-ing special antibacterial drug on the amount of antibacterial drugs and bacterial drug resistance to accumulate experi-ence for promoting rational use of drugs in clinical practice. Methods The average monthly sales amount of the bacte-rial drugs for special use and frequency of drug use (DDDs) were analyzed (from January to June in 2014) before and (from July to December in 2014) after the intravenous drug allocation center participating in the consultation,and at the same time the drug resistance of main pathogenic bacteria against antibacterial drugs for special use was compared by the bacterial drug sensitivity test. Results After the intravenous drug allocation center participating in the consultation, the average monthly sales amount of antibacterial drugs for special use,except imipenem,and frequency of drug use (DDDs) were significantly decreased (P<0.05).Among the bacterial drugs for special use,the amount of Cefepime,Cef-pirome,Vancomycin and Linezolid used decreased obviously.After the intravenous drug allocation center participating in the consultation,the drug resistance rate of the bacterial drugs,except Itraconazole and FushitaYasu,for special use a-gainst Escherichia coli and Pseudomonas aeruginosa,significantly decreased compared with the drug resistance rate of the bacterial drugs be fore the consultation (P<0.05).The drug resistant rate of Meropenem and Imipenem against Bau-manii significantly increased compared with that before the consultation (P<0.05).The drug resistant rate of Meropenem, Imipenem,Linezolid and Teicoplanin against Klebsiella pneumoniae significantly decreased compared with that before the consultation (P<0.05). Conclusion The PIVAS involved in the consultation can ensure the rational use of special use of antimicrobial drugs and delay the bacteria resistance,which provides the guarantee for the scientific and reason-able clinical medication.