摘要
目的:综合评价复旦大学附属华东医院老年内科住院患者莫西沙星注射液临床应用的合理性和安全性,为其临床应用提供依据。方法:采用回顾性研究方法,选取2016年1月-2018年12月使用莫西沙星注射液的老年内科住院患者病例,根据药品说明书和相关指南设计回顾性调查表,进一步收集及分析莫西沙星注射液的临床应用情况。结果:共纳入有效病例374例(60~98岁),莫西沙星临床应用合理率为79.1%,不合理原因主要是用药指征错误,药物选择不当、疗程过长及药物相互作用。临床治疗有效率、微生物送检率、心电图监测率和药物不良反应(ADRs)发生率分别为95.2%、64.2%、53.5%和21.9%,主要的ADRs为血钾降低和QT间期延长。进一步单因素分析显示,冠心病史患者使用莫西沙星后低血钾发生风险显著提高(P<0.05)。结论:临床医师应重视用药前患者的评估,严格把握用药适应证,加强用药期间的临床监测,尤其是心电图和电解质情况,确保老年患者用药的合理性和安全性。
OBJECTIVE To comprehensively evaluate the rationality and safety of moxifloxacin injection in elderly inpatients in the Department of Geriatrics,Huadong Hospital Affiliated to Fudan University,and to provide evidence for its clinical application.METHODS A retrospective study was conducted to select the cases of elderly medical inpatients who used Moxifloxacin Injection from January 2016 to December 2018.A retrospective questionnaire was designed according to the package insert and relevant guidelines to further collect and analyze the clinical application of Moxifloxacin Injection.RESULTS A total of 374 cases(60-98 years old)were included in the study.The rational rate of clinical application of moxifloxacin was 79.1%.The inappropriate medication were mainly contributed to wrong indications,improper drug selection,long course of treatment and improper drug-drug interactions.The clinical treatment response rate,microbiological submission rate,electrocardiographic monitoring rate,and incidence of adverse drug reactions(ADRs)were 95.2%,64.2%,53.5%,and 21.9%,respectively,and the main ADRs were decreased serum potassium and prolonged QT interval.Further univariate analysis showed that the risk of hypokalemia was significantly increased after the use of moxifloxacin in patients with a history of coronary heart disease(P<0.05).CONCLUSION The clinician should pay more attention to the evaluation of patients and medication indications before prescribing,and to strengthen clinical monitoring during medication,especially ECG and electrolytes for ensuring the rationality and safety of treatment in elderly patients.
作者
顾贝欣
吴建博
周海峰
高宁舟
沈杰
熊野娟
GU Bei-xin;WU Jian-bo;ZHOU Hai-feng;GAO Ning-zhou;SHEN Jie;XIONG Ye-juan(School of Pharmacy,Shanghai University of Medicine&Health Sciences,Shanghai 201318,China;Department of Pharmacy,Huadong Hospital Affiliated to Fudan University,Shanghai 200040,China;Department of Pharmacy,Shanghai Pudong Hospital,Shanghai 201399,China)
出处
《中国医院药学杂志》
CAS
北大核心
2020年第10期1150-1153,共4页
Chinese Journal of Hospital Pharmacy
关键词
莫西沙星
疗效
合理性
安全性
药物不良反应
moxifloxacin
efficacy
rationality
safety
adverse drug reactions
