OBJECTIVE: To establish special evaluation standard for antibiotics rational use in the inpatients with community-acquired pneumonia (called “CAP special evaluation standard” for short), and to evaluate its effects. METHODS: Referring to related guideline, specification and drug package inserts, etc., after consulting with physicians in infection related departments, clinical pharmacists established “CAP special evaluation standard” of our hospital from 7 aspects of drug selection, usage and dosage, medication duration, drug combination indications, drug combination compatibility, drug replacement and medication related examination. 50 CAP inpatients were selected from respiratory medicine department of our hospital by lot drawing method during Jan.-Jun. 2014 (before intervention group) and Jan.-Jun. 2015 (after intervention group). Above standards were used as basis for special evaluation intervention, and the application of antibiotics and therapeutic efficacies were compared between 2 groups before and after intervention. RESULTS: After CAP special evaluation, rational rate of drug selection, medication duration, drug combination indications, drug combination compatibility, whole medication increased from 56.00%, 68.00%, 90.00%, 92.00% and 30.00% to 88.00%, 98.00%, 100%, 100% and 84.00%. In the initial empirical treatment, the ratio of drug combination decreased from 64.00% to 32.00%, and the utilization ratio of drug combination indications rose from 71.86% before intervention to 100% after intervention, with statistical significance(P<0.05). DDDs, AUD and average hospitalization cost of after intervention group were lower than those of before intervention group, but the ratio of average antibiotics cost in hospitalization cost was higher than before intervention group, with statistical significance (P<0.05). Total effective rate of 2 groups was 100%; the proportion of patients with “significant therapeutic efficacy” was increased significantly in after intervention group, but that of patients with “therapeutic efficacy improvement” was decreased significantly, with statistical significance (P<0.05). CONCLUSIONS: The special evaluation intervention based on “CAP special evaluation standard” can improve the use of antibiotics in the CAP inpatients, and it is a useful exploration for the evaluation mode of medication order.
关键词
社区获得性肺炎住院患者专项点评标准临床药师干预抗菌药物合理使用
Keywords
community-acquired pneumoniaInpatientsSpecial evaluation standardClinical pharmacistsinterventionAntibioticsRational use