OBJECTIVE To construct the drug utilization evaluation criteria for Dezocine injection,so as to provide reference for the rational drug use in medical institutions.METHODS On the basis of evidence methodology,relevant guidelines/expert consensus,systematic reviews/meta-analysis were consulted;the evaluation criteria framework for Dezocine injection was established after screening evidence.Delphi method was employed,whereby 28 clinicians and clinical pharmacists from secondary and above-level medical institutions across eight provinces,including Tianjin,Beijing and Shandong,were selected to participate in two rounds of questionnaire surveys.The final indicators were determined based on the experts'enthusiasm coefficient,authority coefficient,and degree of coordination.RESULTS The effective recovery rate of questionnaire was 100%in the first round and 92.86%in the second round;expert authority coefficient was 0.82 in the first round and 0.81 in the second round;the coordination degree of experts in the first round was 0.29,and in the second round was 0.31(P＜0.001).Drug utilization evaluation standard system for Dezocine injection was formed finally,including three dimensions of medication indications,medication process and medication results,with a total of 11 first-level indicators(such as indications,usage and dosage)and 33 second-level indicators(such as labor analgesia and the management of severe pain following major or moderate surgeries combined with other analgesic drugs).The average importance scores for each indicator ranged from 4.08 to 5.00 points,with an overall average score of 4.61 points and coefficient of variation ranging from 0 to 0.19.CONCLUSIONS The drug utilization evaluation criteria for Dezocine injection established based on evidence-based methodology and Delphi method is authoritative and scientific,which provides a reference for subsequent evaluation of the rationality of clinical medication.

An 86-year-old male patient received IV infusions of meropenem (1 g once per 12 hours) combined with ciprofloxacin lactate and sodium chloride injection (200 mg once daily) for pneumonia, respiratory failure, and multidrug resistant Pseudomonas aeruginosa infection suggested by sputum bacterial culture. On the 4th day of treatments, the patient developed a sudden drop in blood pressure, and his pulse could not be measured. ECG monitoring suggested ventricular fibrillation. After the treatments of electric defibrillation and amiodarone injection, his sinus rhythm restored. The next day the patient had another three episodes of ventricular fibrillation. All electrolytes were normal during emergency examination and ECG examination showed that the QT interval was normal. Ciprofloxacin was discontinued and replaced by meropenem combined with fosfomycin, and ventricular fibrillation did not recur. Twenty-six days later, the patient′s pneumonia was aggravated and sputum bacterial culture result showed multidrug resistant Pseudomonas aeruginosa infection, which was sensitive to ciprofloxacin and moderately sensitive to levofloxacin. Then meropenem (the same dosage and usage as before) combined with levofloxacin injection (200 mg once daily) were given. On the fifth day of treatments, the patient developed ventricular fibrillation again and his heart rhythm returned to normal after electric defibrillation and amiodarone treatment. Levofloxacin was discontinued and meropenem combined with fosfomycin were given again. Then ventricular fibrillation did not recur. The patient′s ventricular fibrillation was considered to be possibly related to ciprofloxacin and levofloxacin.

An 86-year-old male patient received IV infusions of meropenem (1 g once per 12 hours) combined with ciprofloxacin lactate and sodium chloride injection (200 mg once daily) for pneumonia, respiratory failure, and multidrug resistant Pseudomonas aeruginosa infection suggested by sputum bacterial culture. On the 4th day of treatments, the patient developed a sudden drop in blood pressure, and his pulse could not be measured. ECG monitoring suggested ventricular fibrillation. After the treatments of electric defibrillation and amiodarone injection, his sinus rhythm restored. The next day the patient had another three episodes of ventricular fibrillation. All electrolytes were normal during emergency examination and ECG examination showed that the QT interval was normal. Ciprofloxacin was discontinued and replaced by meropenem combined with fosfomycin, and ventricular fibrillation did not recur. Twenty-six days later, the patient′s pneumonia was aggravated and sputum bacterial culture result showed multidrug resistant Pseudomonas aeruginosa infection, which was sensitive to ciprofloxacin and moderately sensitive to levofloxacin. Then meropenem (the same dosage and usage as before) combined with levofloxacin injection (200 mg once daily) were given. On the fifth day of treatments, the patient developed ventricular fibrillation again and his heart rhythm returned to normal after electric defibrillation and amiodarone treatment. Levofloxacin was discontinued and meropenem combined with fosfomycin were given again. Then ventricular fibrillation did not recur. The patient′s ventricular fibrillation was considered to be possibly related to ciprofloxacin and levofloxacin.

OBJECTIVE To investigate the variety of main pathogenic bacteria and their resistance in urinary system infection of type 2 diabetes mellitus(T2DM)in endocrinology department of our hospital and find out the best choice antibacterials of application.METHODS By retrospective analysis of clinical history,the results of urine bacterial culture,drug sensitivity reports of T2DM patients with urinary system infection were analyzed.The data were dealed with SPSS 11.0.RESULTS The drugs of experiential therapy were mainly quinolones.And drug resistant rates of Escherichia coli and Staphylococcus epidermidis to levofloxacin and ciprofloxacin were 18.2% and 63.6%,and 16.7% and 50.0% respectively.The treatment periods of 2 groups were(8.4?4.3)d and(10.4?5.4)d,respectively.CONCLUSIONS ?-Lactam/?-lactamase inhibitor and aminoglycosides are the first choice in experiential therapy.Thetreatment periods could be decreased according to bacterial culturingresults.

OBJECTIVE: To probe into the safety and reasonability of TCM injection infusion prescription in outpatient and emergency department of hospitals in Tianjin.METHODS: Infusion prescriptions were randomly collected from outpatient and emergency department of secondary and three-tier hospitals in Tianjin.Reasonability of TCM injection intravenous infusion prescriptions were analyzed in respect of dosage and usage,compatibility and administration route.General information of patients and prescription were recorded.Primary data were classified,summarized and screened using EXCEL and the statistic data were calculated using SPSS11.0 software.RESULTS: 11 medical institutions were included and 2 309 TCM injection infusion prescriptions were collected within 4 days.Dosage and dosing interval of reasonable prescription accounted for 66.91% and 80.60% respectively.The safety compatibility proportion of prescriptions was only 58.64%.CONCLUSION: TCM injection infusion prescriptions in outpatient and emergency department of hospitals in Tianjin are reasonable while there is still some unreasonable compatibility of injection.