Clinical Application Of Antibacterial Agents In 540 Patients With Respiratory Infection

Objective:Investigating and analyzing the present situation of hospitalized patients with respiratory tract infection and the usage of antimicrobial drugs,such as understanding of respiratory system infection patients with the infection of bacteria species and distribution,analysis of the usage of antibiotics and unreasonable place,and the type of the pathogen,the occurrence of adverse reactions,such as for patients with respiratory system infection of clinical rational use of antimicrobial agents to provide certain reference.Methods:Choose a hospital in January 2015-December 2017,540 patients with respiratory system infection was diagnosed,statistics of the patient's age,occupation,gender,laboratory examination,imaging examination,basic diseases,hospital before and after the use of antimicrobial drugs,the use of antibacterial drugs category during hospitalization,name,dosing way,replacement of the drug,combined use and so on,analyzed the current situation of the patients with respiratory system infection and the use of antimicrobial agents;All patients with bronchial lavage specimen and lower digestive tract secretion and sputum specimens according to NCCLS standard and the national clinical laboratory operation rules of drug sensitive test standard separation of pathogenic bacteria,and types of the analysis of the distribution of pathogens and drug resistance etc.Results:1.analysis the clinical data of patients with respiratory system infection in 540 cases of patients with type the following respiratory infection is given priority to,accounted for 95.4%(515/540),one of the most common for chronic bronchitis,chronic cor pulmonale and chronic obstructive pulmonary disease,the proportion were 24.1%(130/540),22.4%(121/540)and 32.0%(173/540).2.The inspection basis for the use of antibacterial drugs is mainly through blood cell analysis,imaging examination,bacterial culture,serum calcitonin detection,etc.3.patients with antibacterial drug usage in 99.1%(535/540),using the eight class 14 kinds of antimicrobial agents,the main kinds of medication for head toxin,cephalosporins and beta lactam/beta lactamase inhibitor,its proportion in 30.8%(213/691),36.2%(250/691)and 20.1(139/691).In terms of drug names,cefminol,piperasiline sodium sulbactam,cefepime and ceftiazole sodium were the most frequently used drugs,accounting for 30.8%,19.4%,16.4% and 15.6% respectively.4.The use of antimicrobial drugs after hospitalization was mainly single drug,accounting for 72.0%(385/535)of all patients.A total of 194 drug changes occurred during the treatment.The combined use of antibacterial drugs is mainly the combined use of two drugs,accounting for 28.0% of the total drug use.Intravenous drip was the main method of antibacterial drug administration in all patients,accounting for 96.9%(518/535)and 4.1%(22/535).5.A total of 33 pathogenic bacteria were isolated from bronchial lavage and sputum specimens,29 of which were gram-negative bacteria.The main gram-negative bacteria were klebsiella pneumoniae,pseudomonas aeruginosa,acinetobacter baumannii,escherichia coli,maltophilus stenosa and enterobacter cloacae.The rest were gram-positive cocci(enterococcus and staphylococcus aureus)and fungi(candida albicans).Of gram-negative bacilli to piperacillin sodium sodium,beauty e.faecalis he azole,imine south,amikacin and cefazolin sodium pp ketone shu ba jotham sodium sensitivity is higher,to cefazolin sodium,ampicillin sodium shu ba,amoxicillin clavulanic acid,compound new Ming and cefoxitin resistance high.Gram positive bacteria for drug sensitive test,found that the clindamycin,penicillin,ampicillin,erythromycin,such as high resistance,for vancomycin,rina thiazole amine and compound new Ming high sensitivity.The fungi were more sensitive to fluconazole and voriconazole.Of 540 patients,92 had drug resistance.Drug resistance was mainly against 1-2 antibacterial drugs,60.9% in total,and generic resistance and multiple resistance accounted for 39.1%.6.The maximum time of adverse reactions after medication was 6d,and the shortest time was 10 min,with an average of 2.2h.Among them,66 of 540 patients had adverse reactions,accounting for 12.2%.Severe adverse reactions occurred in 9 patients,accounting for 13.6%.The number of patients with allergic reactions was the highest,accounting for 30 cases,accounting for 45.5% of the total incidence of adverse reactions.