中国医院用药评价与分析2025，Vol.25Issue(11)：1291-1295,5.DOI:10.14009/j.issn.1672-2124.2025.11.003
临床药师主导的基于PK/PD理论的个体化药学服务对碳青霉烯类抗菌药物临床合理使用的效果评价
Evaluation on Effect of Individualized Pharmaceutical Care Based on PK/PD Theory Led by Clinical Pharmacists on Rational Clinical Use of Carbapenem Antibiotics
摘要
Abstract
OBJECTIVE:To assess the effect of individualized pharmaceutical care based on pharmacokinetic(PK)/pharmacodynamic(PD)theory on the rational clinical use of carbapenem antibiotics.METHODS:Through historical comparative research,the discharge medical records of patients with carbapenem antibiotics were collected.The patients admitted from Jun.to Dec.2021 were selected as the control group(n=215),and those admitted from Jun.to Dec.2024 were selected as the observation group(n=502).The control group was only provided with general pharmaceutical services such as publicity on the rational use of antibiotics and routine training for clinical pharmacists.The observation group received individualized pharmaceutical services based on PK/PD theory provided by clinical pharmacists,including pharmaceutical monitoring,prescription review,consultation,and multidisciplinary case discussions,in addition to the services of the control group.The rational use of carbapenem antibiotics and improvement of diseases before and after the individualized medication intervention were analyzed.RESULTS:RESULTS:After the individualized medication intervention,the treatment course of carbapenem antibiotics in the observation group was more reasonable,and the number of patients with a course of less than or equal to 7 d increased significantly,and the number of patients with a course of more than 14 d decreased significantly,the difference was statistically significant(x2 was 6.142 and 4.004,respectively,P＜0.05).In terms of drug combination,the proportion of patients receiving meropenem in the observation group was lower than that in the control group,but the difference was not statistically significant(x2=0.235,P=0.628).In terms of treatment efficacy,the effective rate of observation group was higher than that of the control group,the difference was statistically significant(x2=4.574,P＜0.05).For antibiotics management,the rate of microbial specimen submission before the use of carbapenem antibiotics in the observation group was 87.05％(437/502),significantly higher than 41.40％(89/215)in the control group,the difference was statistically significant(x2=160.563,P＜0.001).The proportion of patients in the observation group who received consultation for carbapenem antibiotics was 94.43％(339/359),significantly higher than that 67.31％(105/156)in the control group,the difference was statistically significant(x2=67.298,P＜0.001).CONCLUSIONS:The individualized drug intervention based on PK/PD theory led by clinical pharmacists is effective and feasible,which can significantly improve application rationality of carbapenem antibiotics.关键词
碳青霉烯类/抗菌药物/个体化药学服务/药动学/药效学理论/合理用药Key words
Carbapenem/Antibiotics/Individualized pharmaceutical care/Pharmacokinetic/pharmacodynamic theory/Rational drug use分类
医药卫生引用本文复制引用
薛文鑫,王靖欣,赵夕岚,郑山海,孙劲文,范红卫,李晓菲,吴迪,魏庆庆..临床药师主导的基于PK/PD理论的个体化药学服务对碳青霉烯类抗菌药物临床合理使用的效果评价[J].中国医院用药评价与分析,2025,25(11):1291-1295,5.基金项目
国家重点研发计划(No.2021YFC3002204) （No.2021YFC3002204）
应急总医院医学发展科研基金(No.K202109) （No.K202109）
