Research of clinical application rationality for intravenous human immunoglobulin (PH4) in our hospital / 中国药学杂志

ABSTRACT

OBJECTIVE: To evaluate the application profiles and the conformance of clinical diagnostics and instructions indications, relative clinical treatment guidelines of intravenous immunoglobulin(PH4) in our hospital from 2011 to 2012. In addition, the management measures for clinical use in the case of market supply shortage were discussed. METHODS Age, gender, diagnosis, dose, and treatment duration of 650 patients using IVIg in our hospital from 2011 to 2012 were analyzed retrospectively. According to the drug instructions, Chinese Pharmacopoeia Clinical Medication Notice 2010 and relative domestic and foreign clinical treatment guidelines, we evaluated the rationality of medication and the conformance of clinical diagnoses and instruction indications. RESULTS In our 750 valid cases, there were 351 male patients (46. 8%) and 400 female patients (53.2%). Average age of these patients was 30.5 years old (0-101 years). The use of IVIg was distributed in 20 clinical departments of our hospital. Total dosage was 45 842.5 g. Per capita dosage was 61.1 g(2.5-572.5 g). Total cost was 8.396 million yuan. Diseases sorting by sum dosage were systemic lupus erythematosus, myasthenia gravis, Guillain-Barre syndrome, immune thrombocytopenia, polymyositis/dermatomyositis, anti-N-methyl-D-aspartate receptor encephalitis, lymphoma, systemic vasculitis, chronic inflammatory demyelinating polyneuropathy, drug rash, etc. Per capita daily dose was 13.3 g. Per capita course of treatment was 4.5 d (1-32 d). CONCLUSION Among the hospitalized patients using IVIG from 2011 to 2012, 616 cases meet the indications of instruction, accounting for 82. 1%; 134 cases were beyond the indications, accounting for 17.9%. According to the latest domestic and international guidelines, 580 cases corresponded with the recommendations of guidelines, accounting for 77.3%; 18 cases were not recommended by guidelines, accounting for 2.4%; 152 cases were not mentioned in guidelines, accounting for 20.3%. Since the IVIG is rare and the market supply is once lacking, the effective management measures made by our hospital play an important role in ensuring the rational administrations.