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OBJECTIVE:To provide reference for rational use of antibiotics in the clinic. METHODS:In retrospective study, the distribution,composition and drug resistance of pathogens in our hospital during Jan.-Dec. in 2015 were analyzed statistically. RESULTS:In 2015,a total of 9401 specimens were collected in microbiology laboratory of our hospital;pathogens were detect-ed in 1743 specimens with positive rate of 18.54%;1591 strains of pathogens were isolated,mainly from sputum (59.77%), urine (14.775) and blood sample (8.93%). Totally 347 strains of Gram-positive bacteria(21.81%),991 strains of Gram-negative bacteria (62.29%),253 strains of fungus (15.90%)were detected. Top 4 pathogens in the list of amount were Escherichia coli, Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus. S. aureus,Streptococcus pneumoniae and Staphylo-coccus haemolyticus were sensitive to vancomycin,linezolid and sodium fusidate,with resistance rate of 0;resistance rates of them to erythromycin were more than 65%. The resistance rate of S. aureus to penicillin was more than 95%,and S. haemolyticus showed high resistance rate to common antibiotics. Drug resistances of E. coli,K. pneumoniae and P. aeruginosa to carbapenems were all lower than 15%,and they were sensitive to polymyxin with resistance rate of 0. Resistance rate of E. coli to quinolones was more than 50%. CONCLUSIONS:The main pathogens are Gram-negative bacteria in our hospital,drug resistance of them are not satisfactory. Drugs most sensitive to main pathogens include vancomycin,linezolid,carbapenems,etc. The inspection of patho-gen drug resistance characteristics should be strengthened,and antibiotics should be selected rationally and normatively according to the results of drug sensitivity test.
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OBJECTIVE:To evaluate the effects of interventions on the use of human serum albumin in respiratory department of our hospital,and to promote rational clinical drug use.METHODS:According to package inserts,related guideline and literatures of human serum albumin,the evaluation standard of human serum albumin use in respiratory department of our hospital was established with evidence-based medicine method.The comprehensive intervention of human serum albumin use was carried out by means of medical order review,prescription comment,permission setting of information system and performance evaluation.The prescriptions of patients receiving human serum albumin were collected during Jan.-Jul.2015 (pre-intervention group,226 cases)and Jan.-Jul.2016 (post-intervention group,148 cases).Those prescriptions were analyzed statistically in respects of total amount of human serum albumin,per capita amount,average duration,indications,contraindications and rationality,etc.The utilization of human serum albumin was compared between 2 groups before and after intervention.RESULTS:The total amount of human serum albumin,per capita amount and average duration decreased from 18 350 g,(81.2±71.3)g,(7.8±7.2)d before intervention to 7 584 g,(51.2±48.3)g,(4.7±2.1)d after intervention,respectively.The proportion of not in line with the indication stated in Guidelines for Use of Human Serum Albumin,Non-protein Colloidal Solution and Srystalline Solution,the proportion of being contrary to contraindication decreased from 80.1％,50.0％ before intervention to 39.9％,16.9％ after intervention,respectively.The number of patients with serum albumin concentration ≥35 g/L,ranged ≥30-＜35 g/L or ranged ≥20～＜25 g/L before medication in pre-intervention group was more than post-intervention group;the number of patients with serum albumin concentration＜ 20 g/L or ranged 20-25g/L in post-intervention group was more than pre-intervention group.The proportion of patient who took human serum albumin rationally increased from 16.8％ before intervention to 52.7％ after intervention (P＜0.05),there were statistical significances in above-mentioned indexes between before and after intervention.CONCLUSIONS:The comprehensive intervention can effectively reduce the indication,medication course and proportion of unreasonable use of human serum albumin,and improves rational use of human serum albumin.
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OBJECTIVE:To establish early warning mechanisms of antibiotics drug resistance,and to provide reference for ra-tional drug use in the clinic. METHODS:The consumption amount of top 3 to 10 drugs in the list of consumption sum and amount in outpatient prescription and inpatient medical orders of our hospital during 2014 was analyzed statistically,including antibiotics, anti-tumor drugs,drugs for cardiovascular system,drugs for digestive system,biologicals. Top 5 Gram-positive bacterial and Gram-negative bacterial which induced infection in our hospital in Nov. 2014 was analyzed statistically in terms of resistant rate. RE-SULTS:Total consumption sum of drugs was 16 038.28 ten thousand yuan in our hospital in 2014,accounting for 27.95%;antibi-otics drugs accounted for 9.55%(1 531.44 ten thousand yuan) of total consumption sum,drugs for cardiovascular system 3.30%(529.60 ten thousand yuan),drugs for digestive system 8.32%(1 333.68 ten thousand yuan),anti-tumor drugs 2.93%(469.27 ten thousand yuan),and biologicals 3.50%(561.22 ten thousand yuan). 1 575 bacterial samples were detected in Nov. 2014,and bacte-rial were detected in 358 samples with positive rate of 22.73%. 136 Gram-positive bacterial were detected,and top 5 were Staphylo-coccus epidermidis, Staphylococcus aureus, Enterococcus faecalis, Enterococcus faecium and Streptococcus agalactiae. 222 Gram-negative bacterial were detected,and top 5 were Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,Hae-mophilus influenzae and Enterobacter cloacae. CONCLUSIONS:Five categories of drugs used in our hospital is rational compara-tively,and the proprotion of antibiotics in total consumption sum is much lower than other hospitals;control and standardization of antibiotics use has made some achievements.