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目的了解深圳市综合医院二线抗结核病药物相关的抗生素使用情况。方法调查2008年深圳市三家综合医院住院部呼吸内科、消化内科和泌尿内科三个科室245例病例,均按不同科室内住院号顺序依次抽取;门诊部调查4990例病例,按门诊号先后顺序依次抽取。住院病人查阅病案资料,门诊病例查阅门诊处方,分别记录使用的SLD相关的抗生素种类和时间段。结果综合医院住院病人有15.9%的病例有抗生素药物敏感试验,59.6%的病例使用过SLD相关的抗生素,其中以氟喹诺酮类居多,占49.8%,其次是大环内酯类,占9%;氟喹诺酮类的使用大多集中于左氧氟沙星和莫西沙星,而大环内酯类多集中于阿齐霉素和克拉霉素;不同科室中呼吸内科应用较多,占75.1%。8.06%的门诊病例使用了与二线抗结核药物相关的抗生素,其中44.3%的病例使用氟喹诺酮类,55.7%使用大环内酯类;呼吸内科病例使用较多,占42.5%,其次为消化内科占22.5%;178例使用氟喹诺酮类抗生素的病人中,以左氧氟沙星为多,占总数的66.3%,大环内酯内使用以阿奇霉素为主,有79例,占使用大环内酯类病例总数的35.3%,其次是罗红霉素和克拉霉素,各占27.2%和24.6%;使用大环内酯类的科室以呼吸内科为主,病例数占各科室病例总数的46.9%。结论深圳市综合医院住院部和门诊部抗生素以经验用药为主,并都存在氟喹诺酮类和大环内酯类抗生素过度应用的现象。
Objective To understand the second-line anti-tuberculosis drug-related antibiotic use in Shenzhen General Hospital. Methods A total of 245 cases of three departments of Respiratory Medicine, Gastroenterology and Urology in inpatient department of three general hospitals in Shenzhen were surveyed in 2008 according to the hospitalization order of different departments. 4990 cases of outpatients were investigated according to the order of their outpatients Extract. Inpatient access to medical records, outpatient visits outpatient prescriptions were recorded using SLD-related antibiotic types and time periods. Results 15.9% of hospitalized patients in general hospital had antibiotic susceptibility test. 59.6% of patients used SLD - related antibiotics, of which fluoroquinolone was the most common, accounting for 49.8%, followed by macrolide, accounting for 9%. The use of fluoroquinolones mostly focused on levofloxacin and moxifloxacin, while the macrolides were mostly on azithromycin and clarithromycin; respiratory medicine was used more often in different departments, accounting for 75.1%. Eighty-six percent of outpatient cases used antibiotics associated with second-line anti-TB drugs, with fluoroquinolones in 44.3% and macrolides in 55.7%; respiratory medicine was more frequently used, accounting for 42.5%, followed by gastroenterology Accounting for 22.5%. Of the 178 patients with fluoroquinolone antibiotics, levofloxacin was the most common form, accounting for 66.3% of the total. Azithromycin was the most commonly used macrolide in 79 cases, accounting for the total number of macrolide cases , Followed by roxithromycin and clarithromycin, accounting for 27.2% and 24.6%, respectively. The departments using macrolide were mainly respiratory medicine, accounting for 46.9% of the total number of cases in each department. Conclusion The antibiotics in inpatient department and outpatient department of Shenzhen General Hospital are mainly used empirically, and there is a phenomenon that fluoroquinolones and macrolide antibiotics are overused.