目的:了解巩义市人民医院 (以下简称"我院") 碳青霉烯类抗菌药物的应用情况, 为碳青霉烯类抗菌药物的临床应用和监管提供依据.方法:抽取我院2016年7月至2018年6月共2 705份使用碳青霉烯类抗菌药物的病历, 对该类药物临床使用情况进行统计分析.结果:2017年7月至2018年6月, 我院碳青霉烯类抗菌药物的销售金额从2016年7月至2017年6月的362.77万元增至548.36万元, 用药频度 (defined daily dose system, DDDs) 从8 216.76增至13 268.5, 使用强度从1.64 DDDs/ (100人·d) 增至2.20 DDDs/ (100人·d), 增幅均较大;2 705份使用碳青霉烯类抗菌药物的病历中, 使用美罗培南的有2 456份, 使用亚胺培南的有108份, 使用比阿培南的有141份;临床耐药革兰阴性菌增加, 美罗培南临床抗感染效力降低, 细菌对其的敏感性降低, 需要应用新型碳青霉烯类抗菌药物比阿培南.结论:我院碳青霉烯类抗菌药物的应用基本合理, 继续加强管理, 尤其加强新型碳青霉烯类抗菌药物比阿培南的管理, 减少细菌耐药性的产生.%OBJECTIVE: To investigate the application of carbapenems in Gongyi City People's Hospital (hereinafter referred to as "our hospital"), so as to provide references for clinical application and supervision on carbapenems. METHODS: 2 705 pieces of medical history with application of carbapenems from Jul. 2016 to Jun. 2018 in our hospital were extracted and analyzed. RESULTS: From Jul. 2017 to Jun. 2018, the consumption sum of carbapenems in our hospital had risen from 3.627 7 million yuan during Jul. 2016-Jun. 2017 to 5.483 6 million yuan, the defined daily dose system (DDDs) had risen from 8 216.76 to 13 268.5, antibiotics use density had risen from 1.64 DDDs/ (100 people·d) to 2.20 DDDs/ (100 people·d), all with significant increasing; of the 2 705 pieces of medical history with application of carbapenems, 2 456 were meropenem, 108 were imipenem and 141 were biapenem; the number of gram-negative bacteria had increased, the clinical anti-infective efficacy to meropenem and the sensitivity of bacteria had been reduced, which need to apply biapenem, the new type of carbapenem. CONCLUSION: The application of carbapenem in our hospital is basically reasonable, the application of biapenem should be especially strengthened to reduce bacterial resistance.
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