Biswal S, Mishra P, Malhotra S, Puri G D, Pandhi P
Department of Pharmacology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
J Clin Pharmacol. 2006 Aug;46(8):945-51. doi: 10.1177/0091270006289845.
The authors studied the factors affecting drug use pattern, cost of therapy, and the association between the pattern of drug use and survival as well as the duration of stay in a prospective, observational study in an intensive care unit between February and May 2005. Data were collected regarding drugs used, severity of the disease, and their outcome. The mean +/- SD of the Acute Physiology and Chronic Health Evaluation (APACHE III) and Glasgow Coma Scale (GCS) scores of 84 patients were 52.2 +/- 19.4 and 7.5 +/- 2.4, respectively. Although the mean number of drugs at the time of admission to the intensive care unit was 5.3, it increased to 12.9 on the first day and 22.2 during the entire stay. More than 50% of the average expenditure on drugs and nutrition was accounted by antibiotics. Requirement of insulin or inotropes signified an adverse outcome on mortality (odds ratios of 3.43 and 8.44, respectively). In conclusion, there is a tremendous impact of antibiotic use on the cost of therapy in the intensive care unit. The requirement of certain drugs such as insulin and inotropes is of prognostic significance.
作者在2005年2月至5月期间，于一家重症监护病房开展了一项前瞻性观察性研究，以探讨影响药物使用模式、治疗费用的因素，以及药物使用模式与生存率和住院时间之间的关联。收集了有关所用药物、疾病严重程度及其转归的数据。84例患者的急性生理学与慢性健康状况评分系统（APACHE III）和格拉斯哥昏迷量表（GCS）评分的均值±标准差分别为52.2±19.4和7.5±2.4。尽管入住重症监护病房时的平均用药数量为5.3种，但在第一天增加到了12.9种，在整个住院期间则增至22.2种。药物和营养平均支出的50%以上由抗生素占据。胰岛素或血管活性药物的使用预示着死亡的不良转归（比值比分别为3.43和8.44）。总之，抗生素的使用对重症监护病房的治疗费用有巨大影响。某些药物如胰岛素和血管活性药物的使用具有预后意义。
