从药学角度对硫酸黏菌素的临床应用评价与分析

打开文本图片集

中图分类号：R978.1 文献标志码：A

Abstract Objective To analyze and evaluate the clinical application of colistin sulfate in the inpatients of athird grade classA hospital froma pharmaceutical perspective in order to provide references for the rational and optimal use of the drug.MethodsThe electronic medical records of inpatients treated with colistin sulfate from Jauary 2021 to December 2023were retrospectivelyanalyzed，including the general information of patients， distribution of infections， medication，laboratory indicators， microbial results，imaging examinations，adverse reactions，etc.According tothe instructions，guidelines，consensus and literatureof thedrug，therationalityofclinical application of colistin sulfate was evaluated and analyzed in our hospital. ResultsA total of236 inpatients were enrolled in the study，with pulmonary infections being the main cause （93.6%） .All patients underwent pathogenic tests，with the highest detection rate of carbapenem-resistant Acinetobacter baumannii （33.44% .184patients （204号 （77.97% ） received intravenous infusion alone， 40 patients received intravenous infusion combined with nebulized inhalation，and 12 patients received individual nebulized administration. 2Oo patients （84.75%） received intravenous administration with a maintenance dose of 5oo，oo0 units bid.122 patients （51.7%） had a course of medication for less than 10 days， 68 patients for 10～14 days，and 46 patients for more than 14 days.194 patients （82.20% ）received combination therapy with other anti-Gram-negative drugs.There were unreasonable situations in clinical practice， such as inappropriate usage and dosage （11.02%） ， insufficient or prolonged course of medication （52.97%） ，and inappropriate combination therapy （33.47%） ）.The clinical effective rate of treating 236 patients with colinstin sulfate was 45.98% ，and 28patients （11.86% ）had acute renal injury during the treatment. Conclusion Further exploration and standardization are needed for the clinically rational application of colistin sulfate in patients with severe infections.Clinical pharmacists should participate in the treatment process of such patients to provide personalized treatment suggestions based on guidelines/consensus，strengthen pharmaceutical care，and closely monitor the occurrence of adverse reactions.

Key wordsColistin sulfate; Rational drug use; Acute renal injury; Medication evaluation

近年来，抗微生物药物耐药性已被世界卫生组织列为全球十大公共卫生威胁之一，给人类健康带来了沉重的疾病负担。（剩余17098字）