Establishment And Application Of Evaluation Criteria For Polymyxin B Drug Utilization

Objective Establish the drug utilization evaluation(DUE)standard of polymyxin B,to evaluate the clinical application of polymyxin B in hospital and improve the rationality and standardization of clinical medication.Method Based on the polymyxin B drug instructions,domestic expert consensus,clinical diagnosis and treatment methods,international authoritative guidelines,antibacterial drug management methods and literature research,the expert consultation method is used to establish the evaluation standard of polymyxin B drug utilization,the primary indicators of the evaluation criteria are medication indications,medication process,medication results and medication management.The data of discharged patients using polymyxin B in the First Affiliated Hospital of Nanchang University from January 2019 to April 2021 were collected,based on the established evaluation criteria for polymyxin B drug utilization,analyze the collected clinical data,the distance distribution between each evaluation target and the ideal target is comprehensively evaluated by entropy weight TOPSIS method.The closeness to the ideal scheme is expressed by C value.The closer the C value is to 1,the more the medical records meet the requirements of evaluation indexes.Results 1 According to the evaluation criteria of polymyxin B drug utilization,the evaluation results of the study samples were made: 504 cases of medical records were collected,and 361 effective cases were included in the study,accounting for 71.62%.The standard rates of compliance with medication indications,medication process,medication management and medication results were 95.29%,1.67%,97.23% and 88.37%respectively.2 Analyze the main items that do not meet the evaluation contents: the drug dose,administration course,infusion time,drug interaction and combined use still need to be improved.The qualified rate of the medication process is the lowest among the four indicators,including 89 cases of unused load dose,230 cases of combined interaction drugs,127 cases of medication course exceeding the standard,41 cases of inappropriate administration frequency The infusion duration was not indicated in 285 cases.3 The entropy weight TOPSIS method makes up for the deficiency of simple statistics,intuitively expresses an evaluation goal that needs to be improved.The target was evaluated based on entropy weight TOPSIS method: there were 202 cases with C value of 1 ～ 0.5.Conclusion 1.The establishment of polymyxin B drug utilization evaluation criteria can effectively evaluate the use of polymyxin B in the hospital,in this study,the drug utilization of polymyxin B mostly appears in the selection of drug dose,combined use with nephrotoxic drugs,infusion time and treatment course.2 In the evaluation criteria,it is suggested that patients who meet the empirical medication can use polymyxin B before obtaining the etiological results,and supplement the procedures as required within 24 hours.The dosage shall be corrected according to the patient’s body weight.The dosage shall be doubled for the first time,and the infusion time shall be more than 1 hour.The maximum early warning value of the total daily dose shall be set.The course of intravenous administration is 10 ～ 14 days.When storage is needed,glucose solution is better than sodium chloride solution.Polymyxin B alone is easy to produce drug resistance.Suggestions on the method and selection of combined drugs are given.Give guidance and suggestions on the basis and method of intracranial administration in central infection.3Establish the evaluation standard of polymyxin B drug utilization,promote the rational use of antibiotics,and provide reference for the standardized use of polymyxin B.