2022 年第 11 期 第 17 卷

替加环素临床应用干预模式的建立与效果评价

Establishment and evaluation of intervention model for clinical use of tigecycline

作者：席庆陶蕾赵程程冯茹武玉洁

英文作者：Xi Qing Tao Lei Zhao Chengcheng Feng Ru Wu Yujie

单位：航空总医院药学部，北京100012

英文单位：Department of Pharmacy General Aviation Hospital Beijing 100012 China

关键词：医务-医保-药学干预模式；替加环素；干预措施；合理用药

英文关键词：Medicaldepartment-medicalinsurance-pharmaceuticalinterventionmodel;Tigecycline;Interventionmeasures;Rationaluseofdrugs

• 摘要：

• 目的 探讨替加环素临床使用的医务-医保-药学干预模式的建立及其应用效果。方法 选取航空总医院使用替加环素的住院患者。参照《替加环素临床应用评价细则》，并结合本院的医疗特色制定替加环素点评标准，临床药师对2018年1—6月(干预前组)本院使用替加环素的情况进行专项点评，对替加环素使用中存在的问题进行汇总和分析，以此为基础制定干预措施，对2019年1—6月（干预后组）本院替加环素的使用进行干预。比较2组患者替加环素使用合理率、抗菌药物相关指标及临床疗效。结果 在适应证、联合用药、用法用量方面，干预后组替加环素使用合理率均高于干预前组［86.7%（78/90）比63.0%（46/73）、92.2%（83/90）比76.7%（56/73）、91.1%（82/90）比74.0%（54/73）］，差异均有统计学意义（均P＜0.05）。干预后组替加环素用药频度、抗菌药物费用和住院药物费用均低于干预前组，差异均有统计学意义（均P＜0.05）。2组临床疗效比较差异无统计学意义（P＞0.05）。结论 药师通过建立替加环素点评标准实施合理用药干预措施，可显著提高其使用合理率，该干预模式的探索与建立对促进安全、有效、合理使用药物具有积极的作用。

• Objective To explore the establishment and evaluation of medical department-medical insurance-pharmaceutical intervention model for the clinical use of tigecycline. Methods Inpatients treated with tigecycline admitted to General Aviation Hospital were enrolled. According to Detailed Rules for Clinical Application Evaluation of Tigecycline and the medical characteristics of our hospital, pharmacists made special comments on the use of tigecycline from January to June 2018 (pre-intervention group), and summarized and analyzed the problems of the use of tigecycline. Based on this to develop interventions, the use of tigecycline from January to June 2019 (post-intervention group) was intervened. The rational rate of tiagocycline use, the related indicators of antibiotics and the clinical efficacy were compared between the two groups. Results In terms of indications, combined medication, and usage and dosage, the rational rates of post-intervention group were higher than those of pre-intervention group ［86.7%（78/90） vs 63.0%（46/73）, 92.2%（83/90） vs 76.7%（56/73）, 91.1%（82/90） vs 74.0%（54/73）］(all P<0.05). The defined daily dose system, antimicrobial drug cost and inpatient drug cost of post-intervention group were lower than those of pre-intervention group (all P<0.05). There was no significant difference in clinical efficacy between the two groups (P>0.05). Conclusion The rational rate of tigecycline significantly increases after pharmacists implemented intervention measures for rational drug use by establishing evaluation standards for tegacycline. The exploration and establishment of this intervention mode has a positive role in promoting the safe, effective and reasonable use of drugs.