摘要
目的:分析2019年—2021年医院上报的抗菌药物相关药物不良反应(adverse drug reactions,ADRs)的临床特点,为临床安全使用抗菌药物提供参考。方法:选取2019年1月—2021年12月南通市第一人民医院上报到国家药品不良反应监测系统的194例抗菌药物相关ADRs报告作为研究资料,统计和分析抗菌药物相关ADRs的患者性别和年龄分布、所涉抗菌药物品类情况、发生时间、累及器官(或系统)及其临床表现、最终转归情况等。结果:194例ADRs的报告类型主要为“一般的”(141例,占72.68%)和“严重的”(49例,占25.26%),所涉药物的剂型主要为注射剂(187例,占96.39%),关联性评价主要为“可能”(102例,占52.58%)和“很可能”(89例,占45.88%);194例ADRs报告中,女性患者比例略高于男性(59.79%vs 40.21%),年龄上<18岁患者的发生比例较高(89例,占45.88%);194例ADRs报告涉及抗菌药物的类型主要为大环内酯类(41例,占21.13%)、青霉素类(37例,占19.07%)、头孢菌素类(37例,占19.07%)和喹诺酮类(36例,占18.55%),涉及品种主要为阿奇霉素(40例,占20.62%)、美洛西林(34例,占17.53%)、莫西沙星(20例,占10.31%)、头孢曲松和左氧氟沙星(15例,占7.73%);194例ADRs中绝大多数发生在用药后的1 d内(166例,占85.57%),其中又以用药后>10~30 min发生较多(66例,占34.02%);194例ADRs主要累及患者皮肤及其附件(99例,占51.03%)、消化系统(27例,占13.92%)、全身性损害(21例,占10.82%)和心血管系统(20例,占10.31%);经过对症处理,194例ADRs患者中痊愈的有42例(占21.64%),好转的有137例(70.62%)。结论:医院临床上患者在使用抗菌药物过程中有较多发生了ADRs,其中部分患者症状较为严重,尽管多数患者经过对症处理可痊愈或好转,但临床仍应加强对抗菌药物不良反应的监测,尤其是阿奇霉素、美洛西林、莫西沙星、头孢曲松和左氧氟沙星等主要品种,以确保患者的用药安全。
Objective:To analyze the clinical characteristics of adverse drug reactions(ADRs)related to antibacterial drugs reported by the hospital from 2019 to 2021,and provide reference for the safe use of antibacterial drugs in clinical practice.Methods:A total of 194 reports of ADRs related to antibacterial drugs reported by Nantong First People’s Hospital to the National Adverse Drug Reaction Monitoring System from January 2019 to December 2021 were selected as the research data,and the distribution of gender and age of patients with ADRs related to antibacterial drugs,the types of antibacterial drugs involved,the time of occurrence,the organs(or systems)involved and their clinical manifestations,and the final outcome were statistically analyzed.Results:A total of 194 cases of ADRs were mainly reported as"mild"(141 cases,accounting for 72.68%)and"serious"(49 cases,accounting for 25.26%).The drugs involved were mainly of a dosage form of injection(187 cases,accounting for 96.39%).The correlation evaluation was mainly"possible"(102 cases,accounting for 52.58%)and"likely"(89 cases,accounting for 45.88%).In 194 ADRs reports,the proportion of female patients was slightly higher than that of male patients(59.79%vs 40.21%),and the proportion of patients younger than 18 years old was higher(89 cases,accounting for 45.88%).The types of antibacterial drugs involved in 194 ADRs reports were mainly macrolides(41 cases,accounting for 21.13%),penicillins(37 cases,accounting for19.07%),cephalosporins(37 cases,accounting for 19.07%)and quinolones(36 cases,accounting for 18.55%).The main types involved were azithromycin(40 cases,accounting for 20.62%),mezlocillin(34 cases,accounting for17.53%),moxifloxacin(20 cases,accounting for 10.31%),ceftriaxone and levofloxacin(15 cases,accounting for7.73%).Most of the 194 cases of ADRs occurred within 1 day after medication(166 cases,accounting for 85.57%),of which the majority occurred within 10-30 minutes after medication(66 cases,accounting for 34.02%).194 cases of ADRs mainly involved the skin and its adnexa(99 cases,accounting for 51.03%),digestive system(27 cases,accounting for 13.92%),systemic damage(21 cases,accounting for 10.82%)and cardiovascular system(20 cases,accounting for10.31%)of the patients.After symptomatic treatment,42 of the 194 patients with ADRs recovered(accounting for21.64%)and 137 improved(accounting for 70.62%).Conclusion:In hospital clinic,patients have more ADRs during the use of antibacterial drugs,and some of them have serious symptoms.Although most of them can recover or improve after symptomatic treatment,clinical monitoring of adverse reactions of antibacterial drugs should be enhanced,especially for azithromycin,mezlocillin,moxifloxacin,ceftriaxone,levofloxacin and other major varieties to ensure the drug use safety of patients.
作者
李新帅
周佳琦
侯荣华
陈霞
LI Xin-shuai;ZHOU Jia-qi;HOU Rong-gui CHEN Xia(Nantong First People's Hospital,Nantong Jiangsu 226000,China)
出处
《抗感染药学》
2022年第11期1569-1574,共6页
Anti-infection Pharmacy
基金
江苏省药学会-恒瑞医院药学基金项目(编号:H202047)
南通市卫生和计生委员会青年医学人才科研基金(编号:QB2019002)
关键词
抗菌药物
药物不良反应
临床特点
用药安全
antibacterial drug
adverse drug reaction
clinical characteristics
drug use safety
