In the present study, we aimed to evaluate the intervention effect of prophylactic antibiotic use in thyroid surgery in a large hospital. From 2004 to 2012, 70 patients who underwent thyroid surgery were randomly sele...In the present study, we aimed to evaluate the intervention effect of prophylactic antibiotic use in thyroid surgery in a large hospital. From 2004 to 2012, 70 patients who underwent thyroid surgery were randomly selected each year. The quality of surgical antibiotic prophylaxis （SAP） was assessed each year in terms of antibiotic ratio, choice, duration, timing, combination, route of administration and so on. The result showed that the SAP ratio was 100% from 2004 to 2010. With our intervention, this SAP ratio was decreased to 45.7% in 2011, and it reached 2.9% in 2012. The AUD was consistently greater than 38 before 2010, while it rapidly declined to 1 in 2012. The number of DDDs per 100 operations was decreased from 431 to 3 after the intervention. The average cost of antibiotic drugs per patient was RMB 350.65 in 2010, whereas it was decreased to RMB 18.51 in 2012. The average duration of hospitalization showed no difference during the intervention. This study indicated that implementation of a multi-disciplinary protocol and clinical pharmacist interventions could improve the rational use of SAP.展开更多
目的:探究白假丝酵母的耐药率变迁与抗真菌药物使用强度(antibiotics use density,AUD)之间的相关性,为临床合理使用抗真菌药物提出参考。方法:抽取2013年—2018年医院住院病区收治的疑似真菌感染患者标本中分离出的白假丝酵母4026株,...目的:探究白假丝酵母的耐药率变迁与抗真菌药物使用强度(antibiotics use density,AUD)之间的相关性,为临床合理使用抗真菌药物提出参考。方法:抽取2013年—2018年医院住院病区收治的疑似真菌感染患者标本中分离出的白假丝酵母4026株,分析其对常用抗真菌药物的耐药率及其变化趋势,并采用Pearson法分析白假丝酵母的耐药率与常用抗真菌药物使用强度的相关性。结果:2013年—2018年分离出4026株白假丝酵母的药敏结果显示,其对氟康唑、伊曲康唑和伏立康唑的耐药率为3.42%~11.18%,呈现逐年升高趋势(P<0.05);而其对5-氟胞嘧啶的耐药率低于前3种抗真菌药物;但6年间其对两性霉素B的耐药率为0.00%;白假丝酵母对氟康唑、伊曲康唑和伏立康唑的耐药率与氟康唑的AUD呈显著正相关(r=0.908,P_(0.012)<0.05;r=0.939,P_(0.005)<0.05;r=0.838,P_(0.037)<0.05);对氟康唑和伊曲康唑的耐药率与卡泊芬净的AUD呈显著正相关(r=0.828,P_(0.042)<0.05;r=0.849,P_(0.033)<0.05)。结论:临床氟康唑和卡泊芬净的AUD与白假丝酵母对氟康唑等唑类抗真菌药物的耐药率具有高度正相关,规范合理使用氟康唑和卡泊芬净有利于降低白假丝酵母的耐药率。展开更多
目的分析近7年大肠埃希菌及肺炎克雷伯菌耐药率与抗菌药物使用强度(antibiotics use density,AUD)的相关性,为临床合理使用抗菌药物提供参考。方法回顾性分析该院2016—2022年大肠埃希菌及肺炎克雷伯菌的耐药率与同期主要抗菌药物的AUD...目的分析近7年大肠埃希菌及肺炎克雷伯菌耐药率与抗菌药物使用强度(antibiotics use density,AUD)的相关性,为临床合理使用抗菌药物提供参考。方法回顾性分析该院2016—2022年大肠埃希菌及肺炎克雷伯菌的耐药率与同期主要抗菌药物的AUD,采用Pearson相关性分析法分析两者的相关性。结果大肠埃希菌对对哌拉西林/他唑巴坦的耐药率与头孢呋辛的AUD呈正相关(P<0.05);对头孢吡肟的耐药率与头孢西丁、氨曲南的AUD呈正相关(P<0.01、P<0.05);对头孢西丁的耐药率与头孢西丁的AUD呈正相关(P<0.05);对亚胺培南的耐药率与头孢哌酮/舒巴坦、阿米卡星的AUD呈正相关(P<0.01)。肺炎克雷伯菌对阿莫西林/克拉维酸的耐药率与头孢西丁、氨曲南的AUD呈正相关(P<0.01);对哌拉西林/他唑巴坦的耐药率与头孢西丁的AUD呈正相关(P<0.05),对头孢噻肟的耐药率与阿莫西林/克拉维酸的AUD呈正相关(P<0.01);对头孢吡肟的耐药率与头孢西丁、左氧氟沙星的AUD呈正相关(P<0.05);对阿米卡星的耐药率与头孢他啶、头孢噻肟、亚胺培南的AUD呈正相关(P<0.01、P<0.05)。大肠埃希菌对哌拉西林/他唑巴坦的耐药率与头孢唑啉的AUD呈负相关(P<0.05);对头孢唑啉的耐药率与头孢他啶、头孢噻肟的AUD呈负相关(P<0.05);对头孢吡肟的耐药率与哌拉西林/他唑巴坦、头孢噻肟的AUD呈负相关(P<0.05);对头孢西丁的耐药率与头孢噻肟的AUD呈负相关(P<0.05);对亚胺培南的耐药率与阿莫西林/克拉维酸的AUD呈负相关(P<0.05)。肺炎克雷伯菌对阿莫西林/克拉维酸的耐药率与哌拉西林/他唑巴坦的AUD呈负相关(P<0.05);对头孢西丁的耐药率与哌拉西林/他唑巴坦的AUD呈负相关(P<0.05)。结论大肠埃希菌及肺炎克雷伯菌的耐药率与多种抗菌药物的AUD相关,应加强抗菌药物的合理管控,延缓细菌耐药的发生。展开更多
文摘In the present study, we aimed to evaluate the intervention effect of prophylactic antibiotic use in thyroid surgery in a large hospital. From 2004 to 2012, 70 patients who underwent thyroid surgery were randomly selected each year. The quality of surgical antibiotic prophylaxis （SAP） was assessed each year in terms of antibiotic ratio, choice, duration, timing, combination, route of administration and so on. The result showed that the SAP ratio was 100% from 2004 to 2010. With our intervention, this SAP ratio was decreased to 45.7% in 2011, and it reached 2.9% in 2012. The AUD was consistently greater than 38 before 2010, while it rapidly declined to 1 in 2012. The number of DDDs per 100 operations was decreased from 431 to 3 after the intervention. The average cost of antibiotic drugs per patient was RMB 350.65 in 2010, whereas it was decreased to RMB 18.51 in 2012. The average duration of hospitalization showed no difference during the intervention. This study indicated that implementation of a multi-disciplinary protocol and clinical pharmacist interventions could improve the rational use of SAP.
文摘目的:探究白假丝酵母的耐药率变迁与抗真菌药物使用强度(antibiotics use density,AUD)之间的相关性,为临床合理使用抗真菌药物提出参考。方法:抽取2013年—2018年医院住院病区收治的疑似真菌感染患者标本中分离出的白假丝酵母4026株,分析其对常用抗真菌药物的耐药率及其变化趋势,并采用Pearson法分析白假丝酵母的耐药率与常用抗真菌药物使用强度的相关性。结果:2013年—2018年分离出4026株白假丝酵母的药敏结果显示,其对氟康唑、伊曲康唑和伏立康唑的耐药率为3.42%~11.18%,呈现逐年升高趋势(P<0.05);而其对5-氟胞嘧啶的耐药率低于前3种抗真菌药物;但6年间其对两性霉素B的耐药率为0.00%;白假丝酵母对氟康唑、伊曲康唑和伏立康唑的耐药率与氟康唑的AUD呈显著正相关(r=0.908,P_(0.012)<0.05;r=0.939,P_(0.005)<0.05;r=0.838,P_(0.037)<0.05);对氟康唑和伊曲康唑的耐药率与卡泊芬净的AUD呈显著正相关(r=0.828,P_(0.042)<0.05;r=0.849,P_(0.033)<0.05)。结论:临床氟康唑和卡泊芬净的AUD与白假丝酵母对氟康唑等唑类抗真菌药物的耐药率具有高度正相关,规范合理使用氟康唑和卡泊芬净有利于降低白假丝酵母的耐药率。
文摘目的分析近7年大肠埃希菌及肺炎克雷伯菌耐药率与抗菌药物使用强度(antibiotics use density,AUD)的相关性,为临床合理使用抗菌药物提供参考。方法回顾性分析该院2016—2022年大肠埃希菌及肺炎克雷伯菌的耐药率与同期主要抗菌药物的AUD,采用Pearson相关性分析法分析两者的相关性。结果大肠埃希菌对对哌拉西林/他唑巴坦的耐药率与头孢呋辛的AUD呈正相关(P<0.05);对头孢吡肟的耐药率与头孢西丁、氨曲南的AUD呈正相关(P<0.01、P<0.05);对头孢西丁的耐药率与头孢西丁的AUD呈正相关(P<0.05);对亚胺培南的耐药率与头孢哌酮/舒巴坦、阿米卡星的AUD呈正相关(P<0.01)。肺炎克雷伯菌对阿莫西林/克拉维酸的耐药率与头孢西丁、氨曲南的AUD呈正相关(P<0.01);对哌拉西林/他唑巴坦的耐药率与头孢西丁的AUD呈正相关(P<0.05),对头孢噻肟的耐药率与阿莫西林/克拉维酸的AUD呈正相关(P<0.01);对头孢吡肟的耐药率与头孢西丁、左氧氟沙星的AUD呈正相关(P<0.05);对阿米卡星的耐药率与头孢他啶、头孢噻肟、亚胺培南的AUD呈正相关(P<0.01、P<0.05)。大肠埃希菌对哌拉西林/他唑巴坦的耐药率与头孢唑啉的AUD呈负相关(P<0.05);对头孢唑啉的耐药率与头孢他啶、头孢噻肟的AUD呈负相关(P<0.05);对头孢吡肟的耐药率与哌拉西林/他唑巴坦、头孢噻肟的AUD呈负相关(P<0.05);对头孢西丁的耐药率与头孢噻肟的AUD呈负相关(P<0.05);对亚胺培南的耐药率与阿莫西林/克拉维酸的AUD呈负相关(P<0.05)。肺炎克雷伯菌对阿莫西林/克拉维酸的耐药率与哌拉西林/他唑巴坦的AUD呈负相关(P<0.05);对头孢西丁的耐药率与哌拉西林/他唑巴坦的AUD呈负相关(P<0.05)。结论大肠埃希菌及肺炎克雷伯菌的耐药率与多种抗菌药物的AUD相关,应加强抗菌药物的合理管控,延缓细菌耐药的发生。
