ABSTRACT
OBJECTIVE： To provide scientific evidence for establishing perfect rationality evaluation indicator system of antibiotics. METHODS： On the basis of literature research， Delphi method was used to conduct several rounds of consultations on 30 experts in related fields with E-mail and questionnaire field investigation. After several rounds of consultations， rationality evaluation index system for antibiotics was determined. The effective recovery rate of expert consultation questionnaire was used to express the positive coefficient of experts； the authoritative coefficient was used to express the authoritative degree of experts； the index importance assignment and the full score ratio were used to reflect the concentration degree of experts’ opinions； the coefficient of variation and the coefficient of coordination were used to express the coordination degree of experts’ opinions. RESULTS & CONCLUSIONS： After two rounds of consultations， response rates of the questionnaire in two rounds of surveys were 100％ and 96.67％， indicating experts were highly motivated. The authoritative coefficients were 0.91 and 0.88， indicating experts had a high degree of authority. Finally， an evaluation index system for rationality of antibiotics was established， which included four first-level indicators （indications， drug selection， medication process， management indicators） and 35 second-level indicators. Among them， the mean value of importance scoring of first-level indicators ranged from 4.28 to 5.00， the full score ratio from 0.93 to 1.00， the coefficient of variation from 0.00 to 0.15 and the coefficient of coordination was 0.446 （P＜0.001）. While， the mean value of importance scoring of second-level indicators ranged from 3.83 to 4.79； the full score ratio from 0.67 to 1.00； variation coefficient from 0.10 to 0.26 and the coefficient of coordination was 0.115 （P＜0.001）， which indicating the system was reliable.
ABSTRACT
Objective:To analyze the characteristics of infectious diseases from neurology ward and provide reference for the treat-ment. Methods:The consultation record of the neurological patients who suffered infection diseases were retrospectively summarized from January 2011 to December 2013. All the consultation were performed by clinical pharmacists. SPSS 19. 0 software was used to an-alyze the adoption and prognosis of the outcomes. Results:In 439 consultation cases,256 patients(58. 31%)were older than 65 years. Most of the cases were respiratory infection(294 cases,65. 33%),urinary tract infection(40 cases,8. 89%)and intracranial infection(37 cases,8. 22%). There were 510 strains of bacteria isolated by culturing,in which 362 strains were gram-negative bacte-ria(70. 98%),127 strains were gram-positive bacteria(24. 90%)and 21 strains were fungi(4. 12%). The top five of pathogenic bac-teria were Pseudomonas aeruginosa(125 stains,24. 51%),Acinetobacter baumannii(93 stains,18. 24%),Staphylococcus aureus(88 stains,17. 25%),Staphylococcus aureus(68 stains,13. 33%)and Escherichia coli. (32 stains,6. 27%). The detection rates of ESBLs of K. pneumonia and E. coli were 61. 36% and 75. 00%,respectively. Among 125 strains of P. aeruginosa,the sensitive rate to meropenem and inipenem was 65. 8% and 70. 6%,respectively. A. baumannii was highly multidrug resistant,and 21 strains (22. 58%)with pan-drug resistance were isolated. Gram-positive bacteria were highly sensitive to vancomycin and teicoplanin. Totally 35 strains(52. 24%)of MRSA were isolated. The complete adoption rate of consultation opinion was 84. 74%(372 cases),the partial adoption rate was 7. 28%(32 cases),and 35 cases(7. 97%)were declined. In all the adopted cases(319 cases,78. 96%)showed effectiveness. In the linear correlation analysis,the consultation adoption and therapy outcomes had significant correlation(P<0. 01). Conclusion:Clinical pharmacists can improve the efficiency in anti-infection therapy and play important roles in the treatment of infec-tious diseases in neurology ward,especially in the treatment of drug-resistant bacterial infections.