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抗菌药物相关性脑病高风险人群抗感染治疗临床药学路径的建立与应用
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| 篇名： | 抗菌药物相关性脑病高风险人群抗感染治疗临床药学路径的建立与应用 |
| TITLE： | Establishment and application of clinical pharmaceutical pathway of anti-infective treatment for high-risk populations of antibiotic-associated encephalopathy |
| 摘要： | 目的 建立抗菌药物相关性脑病（AAE）高风险人群抗感染治疗临床药学路径，并分析其应用效果。方法临床药师根据文献资料和专家意见自制“AAE高风险人群筛查表”和“抗菌药物AAE发生风险比较表”，在此基础上建立我院“AAE高风险人群抗感染治疗临床药学路径”。采用前瞻性、非随机对照研究，将2023年5月至2024年4月我院内科收治的肺部感染患者分为观察组（50例）和对照组（50例）。观察组由临床药师参与并按照临床药学路径制定抗感染方案并进行治疗，对照组由临床医师给予常规抗感染治疗。观察2组AAE发生情况、抗菌药物使用的合理性和初始抗感染治疗有效性，总结AAE病例的干预措施及转归。结果初步建立我院AAE高风险人群抗感染治疗临床药学路径。应用效果分析显示，观察组和对照组分别有1例和8例患者发生AAE，观察组AAE发生率显著低于对照组，抗菌药物使用合理率、初始抗感染治疗有效率均显著优于对照组（P＜0.05）。停药、换药是AAE首选的有效干预措施，脑病治疗药物可作为症状缓解的辅助措施，及时有效地干预有利于症状快速缓解，AAE总好转率为88.89%。结论AAE高风险人群抗感染治疗临床药学路径可有效预防AAE的发生，同时有助于提高用药合理性和初始抗感染方案的有效性，改善发生AAE患者的治疗结局。 |
| ABSTRACT： | OBJECTIVE To establish a clinical pharmaceutical pathway of anti-infective therapy for high-risk populations of antibiotic-associated encephalopathy （AAE）， and analyze its application effects. METHODS Clinical pharmacists developed the “AAE High-Risk Population Screening Form” and “Antibiotic AAE Risk Comparison Form” based on literature and expert opinions， and established the “Clinical Pharmaceutical Pathway of Anti-infective Treatment for AAE High-Risk Population” in our hospital. A prospective， non-randomized controlled study was conducted from May 2023 to April 2024， including 50 cases in the observation group and 50 cases in the control group among patients with pulmonary infections admitted to the Dept. of Internal Medicine in our hospital. The observation group was involved in the development of an anti-infective treatment following the clinical pharmaceutical pathway by clinical pharmacists， while the control group received routine anti-infective treatment by clinical physicians. The occurrence of AAE， the rational antibiotic drug use， and the effectiveness of initial anti-infective treatment in the two groups were observed， and the intervention measures and outcomes of AAE cases were summarized. RESULTS The anti-infective treatment clinical pharmaceutical pathway for AAE high-risk population was preliminarily established in our hospital. The analysis of the application effects showed that there was 1 case of AAE in the observation group and 8 cases in the control group， with a significantly lower incidence of AAE in the observation group than in the control group； the rational antibiotic drug use and the effectiveness of initial anti-infective treatment in the observation group were both significantly superior to those in the control group （P＜0.05）. Drug withdrawal and dressing change were the preferred effective intervention measures for AAE， and encephalopathy treatment drugs could be used as auxiliary measures for symptom relief. Timely and effective intervention was conducive to rapid symptom relief， with a total improvement rate of AAE of 88.89%. CONCLUSIONS The anti-infective treatment clinical pharmaceutical pathway for AAE high-risk population can effectively prevent the occurrence of AAE as well as contribute to promoting rational drug use and the effectiveness of initial anti-infection plans and strengthening treatment outcomes. |
| 期刊： | 2024年第35卷第21期 |
| 作者： | 杜春辉；万永丽；杨晓姣；周瑾；王建博；赵振宇 |
| AUTHORS： | DU Chunhui，WAN Yongli，YANG Xiaojiao，ZHOU Jin，WANG Jianbo，ZHAO Zhenyu |
| 关键字： | 抗菌药物相关性脑病；临床药学路径；抗感染；神经毒性；个体化用药；合理用药；高风险人群筛查 |
| KEYWORDS： | antibiotic-associated encephalopathy； clinical pharmaceutical pathway； anti-infection； neurotoxicity； personalized |
| 阅读数： | 7 次 |
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