易蕾 崔颖 康焕珍

[摘要]目的对某院碳青霉烯类抗生素的应用现状进行调查与分析，探讨其用药合理性。方法本研究选取武汉科技大学附属天佑医院2018年1月至2019年12月485例应用碳青霉烯类抗生素的患者为研究对象，从使用科室分布情况、品种临床应用情况、用药合理性评价情况共三个方面进行统计与分析。结果使用科室分布情况以重症医学科、呼吸内科和中西医结合科为主;品种临床应用情况以美罗培南和亚胺培南西司他汀使用频次最高;用药合理性评价情况，不合理用药病例占比为23.92%，以用法用量及配伍和病原学及疗效评估不合理原因居前，分别达到9.28%和5.57%。结论某医院碳青霉烯类抗生素的临床应用应加强管理，以促进碳青霉烯类抗生素的规范使用。

[关键词]碳青霉烯类;抗生素;用药合理性;美罗培南;亚胺培南西司他汀

[中图分类号] R95 [文献标识码] A  [文章编号]2095-0616（2021）22-0129-05

Application status and analysis of carbapenem antibiotics in a hospital

YI  Lei   CUI  Ying   KANG  Huanzhen

1.Department of Pharmacy， Tianyou Hospital Affiliated to Wuhan University of Science and Technology， Hubei， Wuhan 430064， China;2.Department of Oncology， Tianyou Hospital Affiliated to Wuhan University of Science and Technology， Hubei， Wuhan 430064， China

[Abstract] Objective To investigate and analyze the current situation of carbapenem antibiotics in a hospital， and to explore its medication rationality. Methods A total of 485 cases using carbapenem antibiotics in Tianyou Hospital Affiliated to Wuhan University of Science and Technology from January 2018 to December 2019 were selected as the research objects， and the statistics and analysis were made from three aspects： the distribution of departments using carbapenem antibiotics， the clinical application of varieties and the evaluation of medication rationality. Results The distribution of departments used was mainly the department of intensive medicine， the department of respiratory medicine and the department of integrated traditional Chinese and western medicine. Meropenem and imipenem cilastatin were the most frequently used varieties in clinical application. According to the evaluation of medication rationality， the proportion of cases with irrational drug use was 23.92%， and the irrational reasons of usage and dosage and etiology were the top ones， reaching 9.28% and 5.57%， respectively. Conclusion The clinical application of carbapenem antibiotics in a hospital should be strengthened to promote the standardized use of carbapenem antibiotics.

[Key words] Carbapenems; Antibiotics; Medication rationality; Meropenem; Imipenem cilastatin

碳青霉烯類抗生素是一类非典型性β-内酰胺类抗菌药物（carbapenems），通常不会被大多数质粒和染色体介导的β-内酰胺酶所分解，是目前治疗严重或耐药革兰阴性菌感染的重要药物，特别是在多重耐药菌感染、需氧菌与厌氧菌混合感染等治疗中发挥着重要作用[1]。但随着目前各地使用量和使用强度的逐年上升，耐碳青霉烯类肺炎克雷伯菌和鲍曼不动杆菌耐药率在不断增加，临床使用和管理中存在有一定的不合理现象，为此，我国出台了《国家卫生计生委办公厅关于进一步加……