Multi-centre survey and analysis of individual therapy of antimicrobial agents in children

WANG Jun; WANG Xiaoling; WANG Yang; MEI Yan; PENG Jing; LIU Maochang; XU Hua

doi:10.6039/j.issn.1001-0408.2023.09.20

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Multi-centre survey and analysis of individual therapy of antimicrobial agents in children

更新时间：2023-11-06

- Multi-centre survey and analysis of individual therapy of antimicrobial agents in children
- ZHONGGUO YAOFANG Vol. 34, Issue 9, Pages: 1131-1136(2023)
- 作者机构：
  
  1.华中科技大学同济医学院附属武汉儿童医院药学部，武汉　430016
  2.国家儿童医学中心首都医科大学附属北京儿童医院药学部，北京　100045
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.09.20
  CLC： R969.3;R978
- Published：15 May 2023，
  
  Received：28 September 2022，
  
  Revised：13 March 2023，
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王俊,王晓玲,汪洋等.儿童抗菌药物个体化治疗现状的多中心调查与分析 ^Δ[J].中国药房,2023,34(09):1131-1136.

WANG Jun,WANG Xiaoling,WANG Yang,et al.Multi-centre survey and analysis of individual therapy of antimicrobial agents in children[J].ZHONGGUO YAOFANG,2023,34(09):1131-1136.
王俊,王晓玲,汪洋等.儿童抗菌药物个体化治疗现状的多中心调查与分析 ^Δ[J].中国药房,2023,34(09):1131-1136. DOI： 10.6039/j.issn.1001-0408.2023.09.20.

WANG Jun,WANG Xiaoling,WANG Yang,et al.Multi-centre survey and analysis of individual therapy of antimicrobial agents in children[J].ZHONGGUO YAOFANG,2023,34(09):1131-1136. DOI： 10.6039/j.issn.1001-0408.2023.09.20.

摘要

目的

了解抗菌药物在儿童患者个体化治疗中的开展情况。

方法

对全国30家儿童医院和综合医院儿科开展抗菌药物个体化治疗的情况进行问卷调查，使用Microsoft Excel 2007和SPSS 26.0软件对调查数据进行统计分析。

结果

本次调查共收回75份问卷，其中有效问卷53份，有效率为70.7%。调查发现，86.7%（26/30）的医院以不同形式开展了儿童抗菌药物个体化治疗。临床需求是推动多家医院开展个体化治疗的主要动力，而人员设备不足是最大障碍。开展循证药学、治疗药物监测（TDM）、模型引导的精准用药（MIPD）和抗菌药物相关基因检测的医院占比分别为70.0%、80.0%、30.0%和33.3%。各医院开展TDM的检测方式多样，涉及的儿童抗菌药物以万古霉素和伏立康唑为主。有近一半的药师对MIPD尚不甚了解。

结论

TDM是目前各医疗机构开展儿童抗菌药物个体化治疗的主要方式，但其监测覆盖范围及检测标准均有待提高。MIPD和抗菌药物相关的基因检测技术仍需在临床进一步推广。

Abstract

OBJECTIVE

To investigate the development of individual therapy of antimicrobial agents in pediatric patients.

METHODS

A questionnaire survey was conducted to investigate the individual therapy of antimicrobial agents in 30 children’s hospitals and pediatric departments of general hospitals in China. The survey data was analyzed statistically by Microsoft Excel 2007 and SPSS 26.0 software.

RESULTS

In this survey， 75 questionnaires were collected， and 53 of them were valid with an effective rate of 70.7%. The results showed that 86.7% （26/30） of the hospitals carried out individual therapy of antimicrobial agents in different forms. Clinical needs primarily contributed to the individual therapy in these hospitals， while the insufficient personnel and equipment were the biggest obstacles for individual therapy. The proportions of hospitals， who implemented evidence-based pharmacy， therapeutic drug monitoring （TDM）， model-informed precision dosing （MIPD） and antimicrobial-related genetic tests were 70.0%， 80.0%， 30.0% and 33.3%， respectively. Various detection methods of TDM were carried out in various hospitals， and the antimicrobial agents which needed TDM focused on vancomycin and voriconazole. Moreover， nearly half of pharmacists did not know much about MIPD.

CONCLUSIONS

At present， TDM is the main way to develop individual therapy of antimicrobial agents in various hospitals， but its monitoring coverage and testing standards need to be improved. MIPD and antimicrobial-related gene tests still need to be further promoted in clinical practice.

关键词

抗菌药物儿童个体化治疗治疗药物监测

Keywords

childindividual therapytherapeutic drug monitoring

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Dept. of Pediatrics， the First Affiliated Hospital of Shandong First Medical University （Shandong Provincial Qianfoshan Hospital）/Shandong Engineering and Technology Research Center for Pediatric Drug Clinical Evaluation and Development

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