Effect Of Clinical Pharmacists Intervention On Vancomycin Use In Cancer Hospital

ObjectiveTo establish a standard for the specific use of vancomycin and evaluate the effect of clinical pharmacists on the clinical application of vancomycin by this standard.MethodsBased on the drug label,we established the evaluation criteria for the special use of vancomycin according to the relevant guidelines and clinical use norms;and used the retrospective survey method to evaluate for the rationality of vancomycin of 138 patients before the intervention of the clinical pharmacist(January 1,2015-December 31,2016)and 183 patients after the intervention of the clinical pharmacist(January 1,2017-December 31,2017).For the relevant data involved in the study,SPSS 21.0 statistical software was used for research and analysis,the count data was expressed in percentage(%),and the measurement data was expressed in the form of mean±standard deviation(?x±s),and?~2was used.t was tested and the difference was statistically significant at P<0.05.Results1.There was no significant difference in the general data between the two groups before and after the intervention(P>0.05).2.In the group of before the intervention,the patients involved 16 departments,the most distributed in the hematology department,48 cases(34.78%),while in the group of after the intervention,the patients involved 18 departments,the most distributed in the hematology,68 cases(37.16%).The diagnosis of infection was mainly caused by pulmonary infection,neutropenia with fever and bloodstream infection in the two groups.3.The detection rate in pre-intervention group was 91.06%,the source of the specimen was mostly blood(58.40%),and the positive pathogen was isolated from Staphylococcus aureus.After the intervention,the detection rate was 97.69%.The specimens sent for examination were mainly blood(55.32%),and the positive pathogens were isolated mainly by Staphylococcus aureus.There was a statistically significant difference in the rate of detection before and after intervention(P<0.05).4.Before intervention,the patients with reasonable indications of vancomycin were125 cases(90.58%),130 cases(95.20%)were used reasonably in usage,129 cases(93.48%)were used reasonably in dosage,and 4 cases(26.67%)was reasonable in the timing of preventive administration.94 cases(68.12%)were treated with reasonable treatment course,and 74.80%of the patients used antibiotics in combination.The combination of carbapenems and?-lactamase inhibitors was the main combination.The DUI value of the drug utilization index was 0.78;178 cases(97.27%)were reasonable in indications after the intervention,and 183 cases(100%)were used reasonably in usage.177 cases(96.72%)were used reasonably in dosage.10 cases(100%)with reasonable timing,and 163 cases(89.07%)with reasonable course of treatment.84.39%of patients used antibiotics in combination.The combination of drugs was inhibited by carbapenems and?-lactamase.The compound preparation is mainly composed,and the DUI value is0.90.There were significant differences in the rationality of indications,usage,treatment course,and timing of administration before and after intervention(P<0.05),but there was no significant difference in the rationality of dosage and combination medication(P>0.05).5.Among the pre-intervention patients,106(76.81%)patients underwent renal function monitoring,and 68 patients requiring therapeutic drug monitoring(TDM),of which 12(17.65%)patients were monitored for drug concentration.After intervention,157(85.79%)patients underwent renal function monitoring,and 82 patients required blood drug concentration monitoring,of which 31(37.80%)patients were monitored for drug concentration.There was a statistically significant difference in the rate of renal function monitoring and TDM before and after intervention(P<0.05).6.There were 17 cases(12.82%)of adverse reactions before intervention,mainly renal damage.A total of 22 cases(12.02%)of adverse reactions occurred after intervention,mainly renal damage.There was no significant difference between the two groups before and after intervention(P>0.05).7.The pre-intervention clinical effective rate was 79.71%(110/138),and the overall reasonable number was 72 cases(52.17%).The after intervention clinical effective rate was 86.84%(158/183),and the overall reasonable number was 151cases(82.51%).The difference between the reasonable rate and the effective intervention was statistically significant(P<0.05).ConclusionThe establishment of vancomycin special review criteria can be used to regulate the rational use of vancomycin.After the intervention of clinical pharmacists,the clinical unreasonable use of vancomycin can be reduced,and the rationality of indications,the adjustment of drug usage,and the course of treatment can be improved.Rationality,individualized medication monitoring,and therapeutic effects all have obvious positive effects.