目的 回顧性分析南京中醫(yī)藥大學(xué)附屬南京醫(yī)院碳青霉烯類特殊使用級(jí)抗菌藥物的臨床應(yīng)用情況，評(píng)價(jià)該類藥物使用的合理性，促進(jìn)碳青霉烯類抗菌藥物的合理使用。方法 采用回顧性分析的方法，收集2023年1月1日-2023年6月30日在南京中醫(yī)藥大學(xué)附屬南京醫(yī)院使用碳青霉烯類抗菌藥物364例住院患者的病歷資料，對(duì)患者年齡、感染部位、微生物送檢、病原菌培養(yǎng)、用藥療程、藥物會(huì)診、聯(lián)合用藥和患者用藥后的轉(zhuǎn)歸等情況進(jìn)行分析，并對(duì)該類藥物的用藥合理性進(jìn)行評(píng)估。結(jié)果 364例使用碳青霉烯類抗菌藥物治療的住院患者中以老年人居多，62.6%患者由于肺部感染使用該類藥物治療；用藥前的微生物送檢率為86.8%，主要病原菌為大腸埃希菌、肺炎克雷伯菌及銅綠假單胞菌，用藥療程和聯(lián)合用藥情況基本符合預(yù)期目標(biāo)；會(huì)診率低，尤其是臨床藥師會(huì)診率；治療有效病例數(shù)為311例，占比85.4%；不良反應(yīng)發(fā)生率為1.65%，癥狀均較輕微。結(jié)論 碳青霉烯類抗菌藥物臨床應(yīng)用基本合理，對(duì)不合理情況應(yīng)繼續(xù)加強(qiáng)監(jiān)管，促進(jìn)該類藥物的合理使用。

Objective To analyze the clinical application of carbapenem antibiotics for special use in a hospitals, analyze and evaluate the rationality of these drugs, and promote the rational use of carbapenem antibiotics. Methods A retrospective analysis was used to collect the medical records of 364 patients receiving carbapenem antibiotics in Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine from January 1, 2023 to June 30, 2023. The patients' age, infection site, microorganism examination, pathogen culture, drug duration, drug consultation, combined drug use and patients' prognosis after drug use were analyzed and discussed. The rationality of the drug use was evaluated. Results Most of 364 patients were aged, 62.6% were treated for pulmonary infection. The rate of microbial detection before medication was 86.8%, the main pathogens were Escherichia coli and Klebsiella pneumoniae. The course of medication and the combination of medication basically met the expected target. The consultation rate is low, especially that of clinical pharmacists. The number of effective treatment cases was 311 (85.4%). The incidence of adverse reactions was 1.65%, and the symptoms were mild. Conclusion The clinical application of carbapenem antibiotics in our hospital is basically reasonable, and the unreasonable situation should be further supervised to promote the rational use of carbapenems.