沈陈军，宁　萍，胡秀萍，宋玉清，赵玖玲，王　勇，陈新贵(.滁州市第一人民医院药剂科临床药学室，安徽 滁州　39000； .滁州市第一人民医院心胸外科，安徽 滁州　39000)



滁州市第一人民医院209例抗菌药物不良反应报告及相关因素分析

沈陈军1*，宁萍2，胡秀萍1，宋玉清1，赵玖玲1，王勇1，陈新贵1(1.滁州市第一人民医院药剂科临床药学室，安徽 滁州239000； 2.滁州市第一人民医院心胸外科，安徽 滁州239000)

DOI10.14009/j.issn.1672-2124.2016.03.043

摘要目的：了解滁州市第一人民医院(以下简称“我院”)抗菌药物发生不良反应(adverse drug reaction，ADR)的特点和规律以及引发ADR的相关因素，为临床合理用药提供参考。方法：对我院2011—2013年上报至国家ADR监测中心的209例抗菌药物ADR报告进行回顾性分析，统计患者的性别、年龄、体质量以及ADR名称、级别、结果、药品名称和剂型、给药途径等基本信息。结果：我院发生的抗菌药物ADR中，男性与女性的比例基本持平，女性略高于男性；新的和严重的ADR各有2例，年龄因素中ADR集中发生在儿童、老人和40～50岁阶段，在体质量<60 kg的患者中，年龄≥60岁且<18岁人群的ADR发生比例较高，与18～59岁的比较所占比例分别为67.59%和32.41%；头孢菌素类抗菌药物引发的ADR最多(共88例，占42.11%)，其次为氟喹诺酮类(45例，占21.53%)；静脉用药引发的ADR比例最高(占96.17%)；ADR临床表现多样，以皮肤及其附件损害最多(占55.03%)，其次是消化系统反应(占31.58%)。结论：抗菌药物引发的ADR原因众多且复杂，临床应高度重视，进一步加强其使用监管和临床药师干预，提高其ADR的发现率和上报质量，促进合理用药，降低用药风险，保障患者用药安全。

关键词抗菌药物； 药品不良反应； 合理用药； 用药安全； 报告分析

Analysis on 209 Cases of Adverse Drug Reaction Reports and Related Factors Induced by Antibiotics in the First People’s Hospital of Chuzhou

SHEN Chenjun1, NING Ping2, HU Xiuping1, SONG Yuqing1, ZHAO Jiuling1, WANG Yong1, CHEN Xingui1(1.Dept.of Clinical Pharmacy, the First People’s Hospital of Chuzhou,Anhui Chuzhou 239000, China; 2.Dept.of Cardiothoracic Surgery, the First People’s Hospital of Chuzhou, Anhui Chuzhou 239000, China)

ABSTRACTOBJECTIVE：To investigate the characteristics,regularities and possible related factors of adverse drug reaction (ADR) induced by antibiotics in the First People’s Hospital of Chuzhou(hereinafter referred to as “our hospital”),so as to provide reference for the rational drug use in clinic.METHODS: Retrospective analysis was conducted on 209 cases of ADR reports which had been reported to National ADR Monitoring System during 2011-2013,the general information of patients in terms of the gender,age,weight,name,level and the result of ADR,name and dosage of drug,route of administration were recorded.RESULTS: Of the ADR cases induced by antibiotics,the proportion of female to male were in roughly balance,and female were slightly higher than male.Both the new and serious ADR were 2 cases.The age of ADR cases were mainly the elderly,children and the age within 40-50 years old.The incidence of ADR was relatively high in the weight of cases<60 kg,age of cases ≥60 years old and<18 years old,and compared with the age within 18-59 years old,the proportion were respectively 67.59% and 32.41%.ADR induced by cephalosporin took the lead (88 cases,42.11%),followed by fluoroquinolones(45 cases,21.53%).ADR induced by intravenous route of administration took up the highest proportion.The clinical manifestations of ADR were various,mainly focus on skin and its accessories damage (55.03%),followed by digestive system reactions(31.58%).CONCLUSIONS: ADR induced by antibiotics is very complex and numerous,the clinic are suppose to strengthen the monitoring of antibiotics use and intervention by clinical pharmacists,improve the incidence of ADR and quality of reports,actively promote the rational drug use and reduce the medication risks,so as to ensure the medication safety in patients.

KEYWORDSAntibiotics; Adverse drug reactions; Rational drug use; Medication safety; Reports analysis

药品不良反应(adverse drug reaction，ADR)是指合格药品在正常用法和用量下出现的与用药目的无关的或意外的有害反应。抗菌药物作为临床治疗感染性疾病的主要药物，其广泛使用带来的ADR和细菌耐药情况越来越突出。据2011、2012和2013年国家ADR监测年度报告中指出，3年来抗感染药导致的ADR例次数一直居于首位，分别占化学药总例次数的51.2%、48.8%和47.6%，虽然有逐渐下降的趋势，但总体情况依然严峻[1-3]。为了解滁州市……