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目的:夫西地酸钠的药理作用特殊,对革兰性耐药菌敏感性高,耐受性好。但由于其高耐药风险被列为特殊级管理的抗菌药物。本研究从超说明书用药的角度分析某院儿科住院部夫西地酸钠的使用情况,旨在为儿童感染患者合理使用该抗菌药物提供借鉴。方法:调取儿科3个月内使用夫西地酸钠的46名住院患儿病例,对其在各病区的使用情况、使用方法、疗效和安全性进行分析。结果:夫西地酸钠治疗革兰阳性球菌的效果和安全性得到进一步证实,对检出革兰阳性球菌感染的患儿有效率为100%,总有效率为65.2%;仅发现1例由于输液速度过快导致的静脉痉挛。然而,超说明书用药现象严重,使用方法和使用时机存在诱发耐药菌的风险。46名患儿中,35.3%为超适应证用药(上呼吸道感染、支气管炎、泌尿系统感染);使用频率91.3%与说明书要求不符;34.8%的患儿出现感染后,在没有药敏结果指导的前提下首先选用窄谱的夫西地酸钠治疗;41.4%的夫西地酸钠未与其他抗菌药物联合使用。结论:夫西地酸钠超说明书用药与疗效、安全性和耐药菌的产生密切相关。某些情况下超说明书用药存在合理性,但不合理用药应积极避免。
Objective: Fusidic sodium has special pharmacological effects and high sensitivity to gram-type drug-resistant bacteria and good tolerance. However, due to its high risk of drug resistance is classified as a special class of antimicrobial drugs. In this study, we analyzed the use of sodium fusidate in pediatric inpatient department from the perspective of drug use in order to provide reference for rational use of the antibacterial drug in children with infectious diseases. METHODS: A total of 46 inpatients with fusidic sodium were recruited within 3 months of pediatric use, and their use, efficacy, safety and efficacy in each ward were analyzed. Results: The efficacy and safety of sodium fusidate in the treatment of Gram-positive cocci were further confirmed. The detection rate was 100% for children with gram-positive cocci infection and the total effective rate was 65.2%. Only 1 case was found Infusion speed caused by venous spasm. However, the super manual medication phenomenon is serious, the use of methods and the use of the opportunity to induce the risk of resistant bacteria. Of the 46 children, 35.3% were super-indications (upper respiratory tract infection, bronchitis, urinary tract infection); the frequency of use was 91.3%, which was inconsistent with the instructions; 34.8% of children had no drug- Under the premise of the first selection of narrow-spectrum sodium fusidate treatment; 41.4% of sodium fusidate was not combined with other antibacterial drugs. Conclusion: Fusidic sodium super manual instructions and efficacy, safety and resistant bacteria are closely related. In some cases, super instructions for the use of drugs there is reasonable, but irrational use of drugs should be actively avoided.