Hou Jia, Li Jin-Feng, Yan Xiu-Juan, Zhang Yong-Liang, Zhang Meng-Yu, Zhang Yuan
Department of Pharmacy, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, People's Republic of China.
Patient Prefer Adherence. 2023 Mar 16;17:711-718. doi: 10.2147/PPA.S397873. eCollection 2023.
The purpose of this study was to analyze the improvement effect of clinical pharmacist intervention on renal function impairment in patients with antimicrobial-induced acute kidney injury (AKI).
A total of 145 patients with AKI caused by antibiotics admitted to the ICU department were selected as the research subjects. The patients were divided into the control group (n=57) and the intervention group (n=88) according to whether there were ICU specialist clinical pharmacists involved in clinical treatment. The renal function outcome and infection control were evaluated in the two groups.
The proportion of renal function outcome in the intervention group was 88.6%, which was significantly higher than that in the control group. However, there was no statistically significant difference in infection control between the two groups. For the intervention group, the clinical pharmacists adopted three intervention methods: dose adjustment, drug replacement and CRRT treatment, respectively, according to the disease conditions of AKI patients. Among them, dose adjustment and drug replacement were the most frequently used intervention methods. In addition, the proportion of renal function outcome was higher in the group of patients who changed antibiotics and underwent CRRT, which were 93.1% and 100%, respectively. The adjusted-dose group had the highest infection control rate at 82.1%. However, there were no statistically significant differences in renal function outcomes and infection control among the three interventions.
Clinical pharmacists participating in the clinical treatment of patients with antimicrobial-induced AKI in ICU can effectively improve the renal function of patients.
本研究旨在分析临床药师干预对抗菌药物所致急性肾损伤（AKI）患者肾功能损害的改善效果。
选取入住重症监护病房（ICU）的145例抗生素所致AKI患者作为研究对象。根据是否有ICU专科临床药师参与临床治疗，将患者分为对照组（n = 57）和干预组（n = 88）。评估两组患者的肾功能转归及感染控制情况。
干预组肾功能转归比例为88.6%，显著高于对照组。然而，两组在感染控制方面差异无统计学意义。对于干预组，临床药师根据AKI患者的病情分别采用了三种干预方法：剂量调整、药物更换和连续性肾脏替代治疗（CRRT）。其中，剂量调整和药物更换是最常用的干预方法。此外，更换抗生素组和接受CRRT组的肾功能转归比例较高，分别为93.1%和100%。调整剂量组的感染控制率最高，为82.1%。然而，三种干预措施在肾功能转归和感染控制方面差异均无统计学意义。
临床药师参与ICU抗菌药物所致AKI患者的临床治疗，可有效改善患者肾功能。
