Objective To analyze the rationality of emergency medication in the West China Hospital after Lushan earthquake based on the actual drug use of earthquake victims. Methods We applied DDDs and DUI as evaluation index, input data using Excel software, and analyzed if the emergency medication was required for the injury/illness and the rationality of emergency medication. Results Earthquake victims mainly had trauma and wound infection and they were given antibiotics as main treatment one week after the earthquake. Drugs for the respiratory system and digestive system were mainly used in patients who mainly manifested as non-traumatic diseases and internal diseases four weeks after the earthquake. Among 49 kinds of drugs which could be calculated for the value of DUI, injection accounted for a larger proportion than non-injection (59.18% vs. 40.82%). The results showed that, the medication (DUI=1) only accounted for 12.24%; the medication (DUIlt;1, Mean=0.65) accounted for 38.78%, which implied insufficient drug use; the medication (DUIgt;1, Mean=1.77) accounted for 46.94%, which implied drug overuse. Conclusion Medication for every system is basically timely and rational when treating symptoms and causes in the West China Hospital within one month after Lushan earthquake. However, the rationality of emergency medications using DUI=1 under normal conditions still needs to be further verified.
Objective To evaluate the rationality of drug treatment for cardiovascular diseases in aged people and the effects of evidence-based practice. Methods Descriptive study was conducted to compare the therapies for the patients suffering from cardiovascular diseases before and after evidence-based practice by investigating drug use during 1998-1999 (211 cases) and 2002-2003 (211 cases). Results Among antihypertensive drugs, the ACEIs and diuretics played a more important role than before. CCBs and ACEIs were still the most frequently used drugs, and drug combination was more common, comparing to that before evidence-based practice. Lipid lowering drugs and ACEIs were used more common in coronary heart disease. Quality of life of patients was more emphasized and combination use of anti-anxiety drugs was adopted. When treating heart failure, β-receptor blockers, aldadinc and ACEIs were more frequently used. Conclusions After evidence-based practice, drug use is much more based on evidence instead of experience and textbook. As a result, the rate of reaching ideal blood pressure is higher than before. The rate of rational drug use before and after evidence-based practice has increased from 42% to 78%, respectively.
Objective To investigate drug usage and costs of pneumonia inpatients in Karamay Central Hospital in 2014 and to provide baseline for evidence-based pharmacy study of single disease in respiratory system. Methods The information of drug use and expenditure of pneumonia inpatients were collected from the hospital information system (HIS). We analyzed the data including frequency, proportion and cumulative proportion by Excel 2007 software. Results A total of 309 inpatients were included, among the 78.96% were more than 60 years old. Among the antibiotics single therapy, the frequency of cefoperazone and sulbactam was the highest. Among the antibiotics combination therapy, the frequency of β-lactam antibiotics was the highest. Conclusion Pneumonia inpatients in Karamay Central Hospital are mainly older patients. The β-lactam antibiotics is used most in clinical practice.
A total of 109 varieties of Chinese medicine injections have been approved by the State Food and Drug Administration of China, all of which have the potential to induce adverse drug reactions (ADRs). Major ADRs include systemic anaphylaxis, anaphylactic shock, acute intravascular hemolysis, hepatorenal damage, skin lesion, cardiac damage, respiratory system injury, and gastrointestinal disorders. Contributing factors of ADRs include healthcare workers’ inadequate attention to ADRs of Chinese medicine injections, complex ingredients, allergic uncertainties, and inappropriate drug use in children and the aged. To decrease ADRs resulting from Chinese medicine injections, it is essential to improve the selection of drug indications, delivery of proper dosage regimens, compliance with drug instructions, and selection of solvents for the drugs.
Objective To analyze drug use for 23 sick and wounded hospitalized in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital, during one month after Lushan earthquake, so as to provide references for the drug use for the sick and wounded women and children. Methods Medication information was retrospectively investigated in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital during one month after Lushan earthquake. We extracted data including hospitalization duration, medication prescriptions, types and costs of essential medicines, types and costs of antibiotic medicines using the HIS system. Discharge diagnosis was standardized and classified according to ICD-10. Indicators of rational drug use included defined daily dose (DDD), defined daily dose statistic (DDDs), drug utilization index (DUI), children defined daily dose (cDDD), children drug utilization index (cDUI), proportion of essential medicines, proportion of antibiotic medicines, mismatch of medicine and diagnosis, repeated drug use, improper combination of drug, incorrect usage and dosage, and frequently drug change. Medication information was evaluated and discussed by the prescription working group. Discrepency was resolved by consulting with the panel. Results A total of 23 sick and wounded women and children were assessed during one month after Lushan Earthquake. There were 13 sick and wounded children in the department of pediatrics (mainly manifested as bronchial pneumonia) and 10 sick and wounded women in the department of gynaecology and obstetrics (mainly involved in cesarean delivery). Proportions of essential medicines were 13/13 in the department of pediatrics and 9/10 in the department of gynaecology and obstetrics. Proportions of antibiotic medicines were 10/13 in the department of pediatrics and 8/10 in the department of gynaecology and obstetrics. Irrational drug use was mainly caused by improper use of antibiotics. Conclusion The drug use for 23 hospitalized sick and wounded is rational in the departments of gynaecology, obstetrics and paediatrics in the West China Second University Hospital during one month after Lushan earthquake. Evaluation methods of rational drug use in high-risk population are urgently needed. Using cDDD and cDUI is an active exploration for the evaluation of pediatric drug use, which needs more practice to test and improve.
目的 分析都江堰市人民医院药品不良反应（ADR）的发生情况及引发ADR的相关因素，为临床合理用药及正确评价ADR的发生提供参考。 方法 对医院2009年1月－2011年12月收集上报至全国ADR监测网络的168例ADR报告，进行回顾性分类与统计分析。 结果 ADR报告例数最多的为临床科室，男女病例数比为0.87∶1，静脉给药途径引发的ADR最多（占77.98%）；抗感染药物的ADR发生率最高（占61.90%）；皮肤及其附件损害最常见占（27.98%）。 结论 抗感染药物和中药注射剂是ADR监测的重点药物，应加强ADR监测及相关知识的宣传，提高合理用药水平，减少药源性疾病的发生。
ObjectiveTo probe into the writing quality and rational use of drugs for Emergency Department prescriptions in West China Hospital of Sichuan University. MethodsFrom January 2012 to December 2013, the prescriptions for emergencies were selected randomly. According to prescription management method and standard management of hospital prescription comment requirement, the quality of prescription was analyzed. ResultsFrom 2012 to 2013, the qualified prescription rate increased from 91.45% to 96.70%. The average number of drugs on each prescription was 1 or 2; the utilization rate of antibacterials was below 20.00%; the utilization rate of essential drugs increased from 60.68% to 66.15%; the utilization rate of generic drug name approached 100.00%. However, the utilization rate of injections increased from 82.92% to 85.67%. ConclusionBy prescription reviews, we have listed the problems, and intervened irrational prescription to improve the rate of qualified prescriptions. The high rate of injection utilization is a warning for us to take more effective, more specific and stricter intervention measures.
ObjectiveTo investigate and analyze the antibiotic use in Sichuan Province. MethodsAntibiotic use of inpatients was investigated in 23 hospitals on the day of June 25, 2011. ResultsThe percentage of antibiotic use was 42.4% in the total 27 144 inpatients, the range of which was between 24.3% and 63.3% for each hospital. And 63.8% of the antibiotic use was for therapeutic purpose, and 72.2% used only one antibiotic drug. A total of 36.9% of the patients receiving antibiotic treatment for therapeutic use sent samples for pathogenic detection. With the increase of the size of the hospital (judged by the number of beds), antimicrobial drug utilization decreased with statistical significance (χ2=411.834, P=0.000). With the improvement of regional economic level (judged by per-capita GDP of each region), the hospital antimicrobial usage decreased with statistical significance (χ2=500.093, P=0.000). The three types of antimicrobial drug most frequently used were other β-lactam antibiotics, penicillin and third generation cephalosporin. ConclusionAntibiotic use is reasonable in Sichuan Province as a whole. However, it is necessary to reduce irrational use of antimicrobial agents continuously, and to strengthen the management of clinical antibiotic usage among inpatients.