| 摘要: |
| [摘要]目的：了解我院门急诊儿科吸入用布地奈德混悬液的使用情况，为我院门急诊儿科使用吸入用糖皮质激素提供参考，促进安全合理用药。方法：抽取2020年1月我院门急诊儿科使用吸入用布地奈德混悬液的1 681张处方，对处方的应用科室、患儿年龄、临床诊断、药物用法用量、联合用药等情况进行统计分析。结果：在抽取处方中，急诊儿科使用布地奈德比例为53.66%，门诊儿科使用比例为46.34%。>3~7岁患儿使用布地奈德比例为39.20%，0~3岁患儿使用比例为55.92%，使用患儿主要为婴幼儿及学龄前期儿童。临床诊断有11大类，共26种诊断，其中占比前5位为急性支气管炎（32.54%）、支气管炎（21.77%）、喘息性支气管炎（16.78%）、急性气管炎（9.04%）、支气管肺炎（7.02%），而支气管哮喘只有0.48%，超说明书用药情况严重。单独使用布地奈德混悬液的处方有25张（1.49%），二联用药处方512张（30.46%），三联用药处方922张（54.85%），四联用药处方222张（13.21%），联合用药比例高。超说明书给药频次用药处方共1 554张，给药频次qd处方1 554张（92.44%），给药频次tid处方1张（0.06%），超说明书给药频次使用比例92.50%。结论：布地奈德混悬液主要使用人群为婴幼儿及学龄前期儿童，超说明书使用情况普遍，且联合用药比例高，部分超说明书使用情况缺乏可靠循证证据。建议医院行政管理部门加强超说明书用药管理，结合权威指南制定院内超说明书用药规范，促进临床合理用药。 |
| 关键词: 布地奈德 婴幼儿 联合用药 超说明书用药 用药规范 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2022.05.008 |
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| 基金项目: |
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| Application of Budesonide Suspension for Inhalation in Pediatric Outpatient and Emergency Department of Our Hospital |
| Jiang Jiongpei, Wang Bin, Chen Yubing |
| (Shenzhen Hospital of Integrated Chinese and Western Medicine, Guangdong Shenzhen 518104, China) |
| Abstract: |
| [Abstract] Objective: To investigate the application status of budesonide suspension for inhalation in pediatric outpatient and emergency department of our hospital, so as to provide reference for the use of inhaled glucocorticoids in pediatric outpatient and emergency department of our hospital and promote the safe and rational use of drugs. Methods: A total of 1,681 prescriptions of budesonide suspension for inhalation in pediatric outpatient and emergency department of our hospital in Jan. 2020 were collected and analyzed statistically in the application department, age of children, clinical diagnosis, drug usage and dosage and drug combination. Results: Among the prescriptions drawn, the proportion of budesonide used in pediatric emergency department was 53.66%, and the proportion of pediatric outpatient department was 46.34%. The proportion of children >3 to 7 years old with budesonide was 39.20%, the proportion of children from 0 to 3 years old with budesonide was 55.92%, mainly infants and preschool children. There were 11 categories of clinical diagnoses, including 26 diagnoses, among which the top 5 were acute bronchitis (32.54%), bronchitis (21.77%), asthmatic bronchitis (16.78%), acute bronchitis (9.04%) and bronchopneumonia (7.02%), while bronchial asthma was only 0.48%, indicating serious off-label drug use. There were 25 prescriptions (1.49%) for budesonide suspension alone, 512 prescriptions (30.46%) for dual drugs, 922 prescriptions (54.85%) for triple drugs, and 222 prescriptions (13.21%) for quadruple drugs, indicating high proportion of combination drugs. There were 1,554 prescriptions with off-label administration frequency, 1,554 prescriptions (92.44%) with qd administration frequency, 1 prescription (0.06%) with tid administration frequency, and the proportion of off-label administration frequency was 92.50%. Conclusion: The main users of budesonide suspension are infants and preschool children. Off-label drug use is common, and the proportion of drug combination is relatively high. Some off-label drug use lacks reliable evidence-based evidence. It is suggested that the administrative department of the hospital should strengthen the management of off-label drug use, formulate the specifications of off-label drug use according to the authoritative guidelines, so as to promote the rational clinical drug use. |
| Key words: budesonide infants drug combination off-label drug use drug specifications |
