Analysis of Antibiotic Drug Use in Elderly Patients with Cerebral Infarction Complicated with Pulmonary Infection Consulted by Clinical Pharmacist / 中国药师

ABSTRACT

Objective: To investigate the rational use of antibiotics in the elderly patients with cerebral infarction complicated with pulmonary infection.Methods: A retrospective investigation was used to analyze the drug resistance of 86 cases of elderly patients with cerebral infarction complicated with pulmonary infection.The data were collected from the consultation records of clinical pharmacists in Xuanwu hospital from February 2013 to November 2015.Results: The pathogenic bacteria mainly distributed to Acinetobacter baumannii and Pseudomonas aeruginosa, and the drug resistance rate was 48.89%.After the consultation, the rate of combination therapy increased from 20.23% to 61.63%.After using sensitive antibiotics, such as cefperazone-sulbactam,piperacillin-sulbactar and amikacin, the infectious indices recovered significantly (P＜0.05).The case proportion with BUN/SrCr＞20 in 27 cases complicated with impaired renal function was 62.9%, and although the patients didn''t use antibiotics with reduced doses, the indices of infection and renal function improved in a certain degree (P＜0.05).The case proportion with ALB and PAB decreasing was 53.49%, and after the consultation, all the infectious indices decreased and protein levels increased (P＜0.05).Conclusion: More attention should be paid to the elderly patients with cerebral infarction complicated with pulmonary infection, and sensitive antibiotics with single or combination drug therapy should be used according to the distribution of resistant bacteria.For the renal failure patients, the kind of renal failure should be clear, and then the appropriate dosage of antibiotics should be adjusted.For the patients with malnutrition, adequate protein intake contributes to the recovery of infection.The clinical symptoms and laboratory indices should be integrated to effectively develop rational treatment for the elderly patients with cerebral infarction complicated with pulmonary infection.