Rationality analysis of clinical application of antibacterial drugs and construction of drug resistance prevention and control system
抗菌药物临床应用合理性分析及耐药性防控体系构建

摘要

目的 探讨抗菌药物临床应用合理性分析及耐药性防控体系构建。方法 回顾性方式选取2024年1月-2024年12月期间70例使用抗菌药物的住院患者病历为研究对象，依据《抗菌药物临床应用指导原则》，从用药指征、药物选择、给药方案等方面评估合理性。同时收集病原菌培养及药敏试验结果，分析耐药性数据，并探讨耐药性防控体系构建。结果 70例患者中，抗菌药物应用合理率为70.0%（49/70）；不合理原因主要为用药指征不明确57.1%（12/21）、药物选择不当23.8%（（5/21）。病原菌培养阳性64.3%（45/70），分离出病原菌52株，其中革兰阴性菌占73.1%（38/52）；大肠埃希菌对氟喹诺酮类耐药率达66.7%（12/18），肺炎克雷伯菌对头孢噻肟耐药率66.7%（8/12），金黄色葡萄球菌对青霉素耐药率90.0%（7/8）。结论 当前抗菌药物应用合理性有待提升，耐药性问题突出，需构建一个有效的耐药性防控体系，可有效降低耐药性风险。

Abstract

Objective To explore the rationality analysis of clinical application of antibacterial drugs and the construction of drug resistance prevention and control system.
Methods The medical records of 70 inpatients who used antibacterial drugs from January 2024 to December 2024 were retrospectively selected as the research object. According to the Guiding Principles of Clinical Application of Antibacterials, the rationality was evaluated from the aspects of drug indications, drug selection and drug administration scheme. At the same time, the results of pathogen culture and drug sensitivity test were collected, the drug resistance data were analyzed, and the construction of drug resistance prevention and control system was discussed.
Results In 70 patients, the rational rate of antimicrobial use was 70.0% (49/70). The main reasons for the irrationality were unclear indications (57.1%) and improper drug selection (23.8%) (5/21). The positive rate of pathogen culture was 64.3% (45/70), and 52 strains of pathogens were isolated, of which 73.1% (38/52) were gram-negative bacteria. The resistance rate of Escherichia coli to fluoroquinolones was 66.7% (12/18), Klebsiella pneumoniae to cefotaxime was 66.7% (8/12), and Staphylococcus aureus to penicillin was 90.0% (7/8).
Conclusion   At present, the rationality of antimicrobial application needs to be improved, and the problem of drug resistance is prominent. It is necessary to build an effective drug resistance prevention and control system, which can effectively reduce the risk of drug resistance.