【摘要】 目的评价临床药师参与卒中相关性肺炎(SAP)会诊的效果,为临床药师更好的参与临床治疗提供依据。方法对2013年1月~2015年12月临床药师参与会诊的SAP病例进行分析,包括患者一般情况、会诊目的、病原学分布、抗菌药物应用情况、会诊意见是否采纳、治疗转归等。结果 284例会诊病例中,65岁以上者176例,占61.97%;申请会诊目的主要以指导选择、调整抗菌药物居多,占91.90%;病原学培养阳性病例为187例,阳性率为65.85%;共分离出病原菌227株,前4位病原菌依次为肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌,分别占27.31%、17.18%、14.98%、11.45%;会诊用药以联合用药为主188例,占68.61%,其中用药频次最高的为β-内酰胺类/β-内酰胺酶抑制药、氨基糖苷类、喹诺酮类;会诊建议被全部采纳262例(92.25%),部分采纳11例(3.87%),未采纳11例(3.87%)。患者会诊后痊愈14例(4.93%),好转182例(64.08%),无效50例(17.61%),其他27例(9.50%)。结论临床药师参与会诊已成为临床治疗工作的一部分,在SAP抗感染治疗中起到了积极作用。更多还原

【Abstract】 Objective To evaluate the effect of clinical pharmacists participating in clinical consultation of stroke associated pneumonia(SAP) patients, and to provide reference for clinical pharmacists participating in clinical practice in the future. Methods The consultation data of SAP patients which clinical pharmacists participated in from January2013 to December 2015 were analyzed in following aspects: all the general condition, purpose for consultation, bacterial distribution, application situation of antibacterial agents, whether consultation views were accepted, and the outcomes etc. Results Among 284 consultation cases, 176 cases were older than 65 years, accounting for 61.97%. The main purpose was to adjust or guide the use of antibacterial drugs, accounting for 91.90%. 187 cases were positive in the specimen culture with the positive rate of 65.85%. Totally, 227 strains of pathogens were cultured, and the dominant pathogens were Klebsiella pneumonia(27.31%), Acinetobacter baumannii(17.18%), Pseudomonas aeruginosa(14.98%)and Escherichia coli(11.45%). The consultation medication was dominated by combined drugs in 188 cases(68.61%),of which the β-lactam/β-lactamase inhibitors, aminoglycosides and quinolones were used with the most times. A total of 262 cases of consultation comments(92.25%) were adopted completely, 11 cases(3.87%) were adopted partly, and11 cases(3.87%) were refused. Among the cases which the consultation opinions were adopted, 14 cases were cured(4.93%), 182 were improved(64.08%), 50 were invalid(17.61%), and the others were 27 cases(9.50%). Conclusion The participation of clinical pharmacists in consultation has became a part of medical treatment, and plays an important active role in the anti-infection treatment of SAP patients.更多还原