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中国六大地区七年期间重症监护病房患者使用世界卫生组织不推荐的固定剂量联合抗生素(FNRs)的处方趋势

Prescribing Trends of Fixed-Dose Combination Antibiotics Not Recommended by the WHO (FNRs) for ICU Patients in Six Major Areas of China During a Seven-Year Period.

作者信息

Zhou Liujun, Zhao Yuhua, Zhu Jianping, Liu Jieqiong, Liang Gang, Yang Yi, Han Gang, Yu Zhenwei

机构信息

Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.

Department of Pharmacy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, People's Republic of China.

出版信息

Drug Des Devel Ther. 2024 Dec 6;18:5781-5791. doi: 10.2147/DDDT.S493980. eCollection 2024.

Abstract

OBJECTIVE

To evaluate the prescribing trends of fixed-dose combination antibiotics not recommended by the WHO (FNRs) for intensive care unit (ICU) patients in six major areas of China from 2013 to 2019.

METHODS

A descriptive analysis was conducted using the pharmacy prescription data. Prescription data for patients admitted to the ICU were extracted from the Hospital Prescription Analysis Cooperative Project. Trends in FNR use were analyzed over a seven-year period, and the trends were further analyzed at the specific drug and hospital levels.

RESULTS

A total of 15,596,620 prescriptions were eligible for analysis, and 1,492,793 patients were included. Among these patients, 91,515 (6.13%) received FNRs. The annual number of ICU patients who received FNR showed an increasing trend (P=0.007), but the percentage per year did not (P=0.764). The FNR use was usually higher in male patients than in female patients (P<0.001). Patients aged > 60 years had the highest percentage of patients who received FNRs (P<0.001). Among the eight FNRs identified in this study, cefoperazone/sulbactam was the most commonly used FNR in both patient numbers and prescribed hospitals, followed by piperacillin/sulbactam. The use of cefotaxime/sulbactam was less common but showed an increasing trend. There were significant differences among the regions.

CONCLUSION

This study investigated the national landscape of FNR use among ICU patients. Attention should be given to the frequent use of FNRs in these patients. Data on the real-world effectiveness and safety of FNRs are urgently required.

摘要

目的

评估2013年至2019年中国六个主要地区重症监护病房(ICU)患者使用世界卫生组织不推荐的固定剂量联合抗生素(FNRs)的处方趋势。

方法

使用药房处方数据进行描述性分析。从医院处方分析合作项目中提取ICU住院患者的处方数据。分析了七年期间FNRs的使用趋势,并在特定药物和医院层面进一步分析了这些趋势。

结果

共有15596620张处方符合分析条件,纳入患者1492793例。其中,91515例(6.13%)接受了FNRs。接受FNRs的ICU患者年度数量呈上升趋势(P=0.007),但每年的百分比未呈上升趋势(P=0.764)。男性患者的FNRs使用率通常高于女性患者(P<0.001)。年龄>60岁的患者接受FNRs的比例最高(P<0.001)。在本研究确定的八种FNRs中,头孢哌酮/舒巴坦在患者数量和开具医院方面都是最常用的FNR,其次是哌拉西林/舒巴坦。头孢噻肟/舒巴坦的使用较少,但呈上升趋势。各地区之间存在显著差异。

结论

本研究调查了ICU患者中FNRs的全国使用情况。应关注这些患者中FNRs的频繁使用。迫切需要关于FNRs实际有效性和安全性的数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a67/11632048/a79429cad074/DDDT-18-5781-g0001.jpg

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