Jospital医皖管理论坛InfectionControl合理用药对肺炎克雷伯菌耐药率的影响研究StudyonInfluenceofRationalDrugUseonResistanceRateofKlebsiellaPneumoniae陈斌辉CHENBin-hui梁小龙LIANGXiao-long段琼DUANQiong陈方亮CHENFang-liang摘要Abstract目的从肺炎克雷伯菌(KP)耐药率与抗菌药物用药频度(DDDs)相关性出发，分析合理用药与耐药率的关系，为抗菌药管理提供新思路。方法回顾性调查分析本院2019一2021年KP对常见抗菌药的耐药率和同期DDDs的相关性，并结合DDDs确定重点抗菌药物，再分析抗菌药用药合理性和KP耐药率变化。结果头霉素类、喹诺酮类、大环内酯类的DDDs分别与KP对头孢曲松、阿莫西林克拉维酸钾、哌拉西林/他唑巴坦、复方新诺明的耐药率呈正相关，差异均有统计学意义；抗菌药物哌拉西林钠／他唑巴坦和左氧氟沙星用药合理性均有提高；同期KP对细菌耐药率总体呈下降趋势，其中2019一2021年下降显著。结论KP的耐药率与DDDs存在一定的相关，合理用药可改善细菌耐药率。ObjectiveToanalyzetherelationshipbetweenrationaldruguseanddrugresistancerateofKlebsiellapneumoniae(KP)basedonthecorrelationbetweenKPresistancerateandantibioticdefineddailydose(DDDs),andtoprovidenewideasforantibioticmanagement.MethodsThecorrelationbetweenthedrugresistancerateofKPtocommonantibioticsandtheDDDsinthesameperiodofourhospitalfrom2019to2021wasretrospectivelyinvestigatedandanalyzed.ThekeyantibioticsweredeterminedaccordingtotheDDDsandtherationalityofantibioticdruguse.ThechangeofKPdrugresistanceratewereanalyzed.ResultsTheDDDsofcephamycins,quinolones,andmacrolideswerepositivelycorrelatedwiththeresistanceratesofKPtoceftriaxone,amoxicillin-clavulanatepotassium,piperacillin/tazobactam,andcompoundsulfamethoxazole.Thedifferenceswerestatisticallysignificantrespectively.Therationalityofpiperacillinsodium/tazobactamandlevofloxacinwereimproved.Duringthesameperiod,thebacterialresistancerateofKPshowedanoveralldownwardtrend,withasignificantdeclinefrom2019to2021.ConclusionThereisacertaincorrelationbetweenKPresistancerateandDDDs,andrationaldrugusecanimprovebacterialresistancerate.关键词KeyWords：合理用药Rationaldruguse；抗菌药物Antibiotic；肺炎克雷伯菌Klebsiellapneumoniae;耐...
