目的 基于科研點評與信息化管控分析美羅培南合理用藥情況。方法 回顧性分析2018—2019年天津市北辰醫(yī)院應(yīng)用美羅培南的患者住院病歷，并分析其藥物使用情況、診斷及療程情況、微生物培養(yǎng)后細(xì)菌分布情況及腎功能不全患者美羅培南用藥劑量，并進(jìn)一步按照特殊抗菌藥物相關(guān)指南進(jìn)行合理性評價。結(jié)果 與2018年相比，2019年美羅培南用藥總量增長60.17%、用藥療程增長3.28%、消耗數(shù)量增長60.17%、住院天數(shù)增長173.78%、用藥天數(shù)增長101.76%。所有應(yīng)用美羅培南的患者病例中，診斷包含肺部感染、感染性休克、腹腔感染、膿毒血癥、血流感染、尿路感染、胰腺炎、皮膚感染等。2018年美羅培南平均療程為（6.31±5.01）d，2019年美羅培南平均療程為（5.97±3.02）d，2019年減少了5.39%。2018年132例應(yīng)用美羅培南的患者中，115例行微生物送檢，送檢率87.12%，共培養(yǎng)出33株細(xì)菌。2019年237例應(yīng)用美羅培南的患者中，236例行微生物送檢，送檢率99.58%，共培養(yǎng)出45例菌株。在2018年，132例應(yīng)用美羅培南患者均進(jìn)行腎功能檢查，結(jié)果顯示，58例患者血肌酐（Scr）<62 μmol/L，54例患者Scr 62~115 μmol/L，20例患者Scr>115 μmol/L。其中6例患者內(nèi)生肌酐清除率（Ccr）<50 mL/min，3例未實施給藥劑量及給藥頻次調(diào)整。按照藥物說明書相關(guān)適應(yīng)證及患者臨床病理資料，在2018年132例應(yīng)用美羅培南患者病歷中，不合理應(yīng)用藥物的患者占12.88%（17/132），2019年237例應(yīng)用美羅培南患者病歷中，不合理應(yīng)用藥物的患者占3.80%（9/237）。結(jié)論 通過科研點評與信息化管控可發(fā)現(xiàn)醫(yī)院美羅培南使用存在不合理現(xiàn)象，對患者美羅培南使用情況進(jìn)行分析及點評，有利于規(guī)范美羅培南使用，提高臨床用藥的安全性及合理性。

Objective To analyze the rational use of meropenem based on scientific research review and information management. Methods The medical records of patients with meropenem in Tianjin Beichen Hospital from 2018 to 2019 were retrospectively analyzed, and the drug use, diagnosis and course of treatment, bacteria distribution after microbial culture, and dosage of meropenem in patients with renal insufficiency were analyzed, and the rationality was further evaluated according to the relevant guidelines of special antibacterial drugs. Results Compared with 2018, the total number of meropenem medications increased by 60.17%, the duration of medication increased by 3.28%, the number of consumption increased by 60.17%, the number of hospitalization days increased by 173.78%, and the number of medication days increased by 101.76% in 2019. All patients treated with meropenem were diagnosed with pulmonary infection, sepsis, wound infection, submaxillary lymphadenitis, pancreatitis, acute tonsillitis, sepsis, urinary tract infection, etc. The average treatment course of meropenem was (6.31 ±5.01) d in 2018, and (5.97 ±3.02) d in 2019, which decreased by 5.39% in 2019. In 2018, 115 of the 132 patients treated with meropenem underwent microbial examination, with a detection rate of 87.12%, and a total of 33 bacterial strains were cultured. In 2019, of 237 patients treated with meropenem, 236 were submitted for microbial detection, with a detection rate of 99.58%. A total of 45 strains were cultured. In 2018, 132 patients treated with meropenem underwent renal function tests, and the results showed that serum creatinine (Scr) was < 62 μmol/L in 58 patients, 62-115 μmol/L in 54 patients, and > 115 μmol/L in 20 patients. Among them, 6 patients had endogenous creatinine clearance rate (Ccr) < 50 mL/min, and 3 patients did not adjust dose and frequency of administration. According to the indications and clinicopathological data of the patients, among the 132 cases of meropenem application in 2018, 12.88% (17/132) were found to be irrational use of drugs; among the 237 cases of meropenem application in 2019, 3.80% (9/237) were irrational use of drugs. Conclusion The irrational use of meropenem in hospitals can be found through scientific research review and information control. The analysis and comment on the use of meropenem in patients is conducive to standardize the use of meropenem and improve the safety and rationality of clinical medication.

R978.1