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OBJECTIVE：To provide reference for the ra tional use of carbap enems in tuberculosis patients. METHODS ：Totally 12 576 tuberculosis inpatients were collected from our hospital. Multi-disciplinary team （MDT） model was adopted for carbapenems management in aspects of policy intervention ，technical support and staff training. Average hospitalization duration ， mortality，nosocomial infective rate ，use and drug resistance of carbapenems were compared before （Mar. 2016-Mar. 2017）and after management （Apr. 2017 to Mar. 2019）. Interrupted time series （ITS）analysis was used to analyze the utilization rate of carbapenems，DDDs，the proportion of carbapenems ’DDDs in the total antibiotics ’DDDs，the proportion of carbapenems ’cost in the total antibiotics ’cost before and after management. Pearson correlation analysis was conducted for DDDs of carbapenems with medical quality indicators and detection rate of carbapenems-resistant bacteria. RESULTS ：After the management ，average hospitalization stay ，the cost of antibiotics ，DDDs of carbapenems ，the proportion of carbapenems ’DDDs in the total antibiotics ’ DDDs，the proportion of carbapenems ’cost in the total antibiotics ’cost，the utilization rate of carbapenems ’，and the drug resistance rate of some bacteria to carbapenems were significantly lower than those before the management （P＜0.05）. ITS analysis results showed that after management ，the utilization rate of carbapenems ，DDDs，the proportion of com carbapenems’DDDs in the total antibiotics ’DDDs and the proportion of carbapenems ’cost in the total antibiotics ’cost hhyyzj@126.com were decrease d by 4.491％ ，220.276，6.535％ ，11.747％ ， with statistical significance （P＜0.05）. Co mpared with before management ，above indexes were decreased by 0.330％，17.625， 0.308％，0.304％ monthly，among which the utilization rate and DDDs of carbapenems were decreased significantly （P＜0.05）. Before management ，drug resistance rate of Pseudomonas aeruginosa to carbapenems was 21.80％，and those of Acinetobacter baumannii to meropenem and imipenem were both 4.60％；after management ，drug resistance rate of P. aeruginosa to imipenem was 13.00％，and those of A. baumannii to meropenem and imipenem were both 16.30％，with statistical significance before and after management （P＜0.05）. There was no statistical significance in drug resistance rate of Enterobacteriaceae （P＞0.05）. Pearson correlation analysis showed that carbapenems ’DDDs was significantly positively correlated with average hospitalization duration and antibiotics ’cost（P＜0.05）；imipenem’s DDDs was positively correlated with drug resistance rate of P. aeruginosa （P＜0.05）. CONCLUSIONS： MDT management can effectively standardize the use of carbapenem in tuberculosis patients ， shorten hospitalization duration ，and reduce drug cost ，DDDs and drug resistance rate of some bacteria.
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Objective To describe and explore the practice of eye care in ICU,in order to make a specified training plan and guideline on eye care,and to improve the skill in eye care of ICU nurses. Methods A survey was conducted in 92 ICU nurses from 2 general hospitals in Huizhou city with non-random sampling using a self- made questionnaire to investigate their eye care of patients. Results The nursing practice of eye care in ICU was urged to be improved,there was no standard on eye care. Conclusions The knowledge of ICU nurses needs to be enhanced,and guideline on eye care is urged to be worked out,so that practice of eye care would be improved.
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Objective To investigate the effect of intensive control of residual amount in stomach on prevention of ventilator associated pneumonia(VAP)during the process of enteral nutrition. Methods 96 patients with mechanical ventilation(MV) more than 48 hours were randomly divided into the case group and the control group, they were treated with intensive control and common control of residual amount in stomach respectively. The incidence rate of VAP, mortality rate, time of ventilation and hospitalization time were compared between the two groups. Results The incidence rate of VAP was 20.83% in the case group and mortality rate was 18.75%,the time of MV was(15.21±2.36)days, the hospitalization time was(22.38±12.34)days. The incidence rate of VAP wag 39.58%.mortality rate was 39.58%,the time of MV wag(19.85±4.58)days, the hospitalization time was(29.46±15.24)days in the control group. Conclusions Intensive control of residual amount in stomach could be helpful to decrease the incidence of VAP and mortality rate of patients with mechanical ventilation using nasal feeding, also shorten the time of MV and the hospitalization time.
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OBJECTIVE:To promote plasma concentration monitoring of anti-tuberculosis agents in the clinic.METHODS:Results of plasma concentration monitoring of rifampicin and isoniazid in tuberculosis patients of our hospital from Aug.2005 to Dec.2008 were analyzed retrospectively.RESULTS:Plasma concentration samples were collected from 241 patients treated with rifampicin and 53 patients treated with isoniazid 2 hours after medication.Plasma concentrations of rifampicin in 10.4% of patients were below the normal level and 31.9% were higher than the normal level.Plasma concentrations of isoniazid in 71.7% of patients were below the normal level and 15.1% were higher than the normal level.CONCLUSION:Plasma concentration monitoring of anti-tuberculosis agents is a valuable tool to adjust the dosage of drugs,which is valuable for rational use of drugs in tuberculosis patients.
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0.05) between in 2 groups.CONCLUSION: Used in combination with rifampin,bicyclol showed insignificant effect on the pharmacokinetics of rifampin in rats.