某院2005—2024年儿童抗菌药物不良反应帕累托法分析

    Pareto Analysis of Adverse Drug Reactions Induced by Antibacterial Drugs in Children in a Hospital from 2005 to 2024

    • 摘要:
      目的 分析首都医科大学附属首都儿童医学中心儿童抗菌药物不良反应(adverse drug reactions,ADR)发生规律和特点,为儿童安全用药提供参考。
      方法 收集本院2005年1月—2024年12月上报至国家药品不良反应监测系统的抗菌药物ADR报告382例,对患儿的性别、年龄、给药途径、药品类别、累及系统/器官及临床表现、ADR发生时间、转归及上报人员进行分类,应用帕累托图分析。
      结果 382例ADR报告中,女性157例(41.10%),男性223例(58.38%),性别不详2例(0.52%)。年龄段分布以学龄期(30.37%)、幼儿期(22.51%)和学龄前期(24.35%)为主。静脉滴注是引发ADR的主要给药途径,占比85.19%。头孢菌素类(22.72%)、大环内酯类(21.48%)、糖肽类(13.58%)抗菌药物引发的ADR居多。抗菌药物累及最多的系统/器官是皮肤及附件,高达199例(50.38%)。ADR主要发生在用药后1 d内以及用药后1~2 d。上报人员中,药师上报307例,医师上报71例,护士上报4例。绝大多数ADR经处理后好转或痊愈。
      结论 儿童应用抗菌药物应全面考虑ADR,加强监护,确保临床用药安全。

       

      Abstract:
      OBJECTIVE  To analyze the regularity and the characteristics of adverse drug reactions associated with antibacterial drugs in pediatric patients at Capital Center For Children's Health, Capital Medical University, and to provide reference for safe medication in children.
      METHODS  A total of 382 ADR reports related to antibacterial drugs in children, submitted to the National ADR Monitoring Center from our hospital between Jan 2005 and Dec 2024 were collected. The gender, age, route of administration, drug category, system/organ involved and clinical manifestations, ADR occurrence time, outcome and reporting personnel were classified,and analyzed by Pareto principle.
      RESULTS  Among 382 ADR reports,157 cases(41.10%) were female and 223 cases(58.38%) were male. 2 cases(0.52%) were gender unknown.The age distribution were mainly school age(30.37%), early childhood(22.51%) and pre-school age(24.35%). Most of the cases of ADR were induced by intravenous injection, accounting for 85.19%. Cephalosporins(22.72%), Macrolides(21.48%) and glycopeptides(13.58%) caused the majority of ADR. The injury to the skin and adnexa was the most common ADR, which accounted for 199 cases(50.38%). ADR mainly occurred within 1 day and 1-2 day after medication. Among the reporting staff, 307 cases were reported by pharmacists, 71 cases by physicians and 4 cases by nurses. The most of ADR were improved or recovered after treatment.
      CONCLUSION The application of antibacterial drugs in children should fully consider ADR, strengthen monitoring, and ensure the safety of clinical medication. 

       

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