目的：评价南京市高淳人民医院（以下简称“我院”）的临床万古霉素应用合理性。方法：采用回顾性调查方法，对2012年9月—2014年9月住院患者应用万古霉素合理性进行分析。结果：176例患者中，治疗用药172例，预防用药4例。病例分布最多的科室为脑外科、重症监护中心、呼吸内科。有166例应用万古霉素之前进行了病原学检查，送检的样本只有100例成功分离病菌，45例对万古霉素敏感。合理用药的32例，基本合理用药10例，不合理用药134例，其中涉及用药时间过长27例。结论：我院对应用万古霉素所需的病原学检查与肝、肾功能监测都很重视，但对应用万古霉素较多的混合感染的重症患者，肾功能不全患者或是老年患者，病原学检查缺乏针对性。对此，应加强对万古霉素应用指导，血药浓度监测、病原学监测的力度，提高万古霉素合理用药水平。%OBJECTIVE:To evaluate the application rationality of clinical vancomycin in People's Hospital of Nanjing Gaochun (hereinafter referred to as “our hospital”).METHODS:Retrospective investigation was applied into the analysis of application rationality of clinical vancomycin for inpatients from Sept .2012 to Sept.2014.RESULTS: Of the total 176 cases, 172 cases received therapeutic medication and 4 cases received preventive medication .The departments with most cases of distribution were department of cerebral surgery , ICU and respiratory medicine .There were 166 cases had the test of pathogeny before the application of vancomycin;of the tested samples , only 100 cases had the successful isolation of pathogenic bacteria and 45 cases were sensitive to vancomycin .There were 32 cases with rational drug use , 10 cases with basically rational drug use and 134 cases with irrational drug use , among which 27 cases with overlong time of drug use . CONCLUSIONS:Our hospital attaches importance to the test of pathogeny and monitoring of liver and kidney function that needed in the application of vancomycin , but still lacks of specific evaluation on the test of pathogeny in mixed infection critical patients, chronic renal failure patients or the elderly patients with a large application amount of vancomycin . Therefore, it is necessary to strenghen the application guidance of vancomycin , mornitoring of blood concentration and mornitoring strength of etiology , so as to improve the level of rational application of vancomycin .
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