Practice and Analysis of Clinical Pharmacists Participating in Pharmaceutical Consultation for Children with Urinary Tract Infection / 中国药房

ABSTRACT

OBJECTIVE:To provide reference for clinical pharmacists participating in pharmaceutical consultation for children with urinary tract infection,and to improve rational drug use in clinic. METHODS:The information of 40 children with urinary tract infection consulted by clinical pharmacists were collected retrospectively from Jan. 2016 to Jan. 2017. The detection of pathogenic bacteria in urine culture,drug resistance of Gram-positive bacteria and Gram-negative bacteria to commonly used antibiotics,clinical pharmacist consultation,outcome,the utilization of antibiotics before and after consultation were analyzed. RESULTS:Among 40 children,urine culture of 37 children was positive,and 58 strains were detected. Gram-positive bacteria were mainly Enterococcus faecium and Enterococcus faecalis;resistance rates of E. faecium to penicillin,ampicillin,amoxicillin/clavulanate potassium were 100%;resistance rate of E. faecalis to high-concentration of gentamicin and tetracycline was higher than 50%. Both were completely sensitive to linezolid,vancomycin,teicoplanin, quinupristin/dalfopristin and tigecycline. Gram-negative bacteria were mainly Escherichia coli and Klebsiella pneumoniae;resistance rates of them to penicillin,piperacillin were 100%;all of them showed low resistance to amikacin(21.43% to E. coli,20.00% to K. pneumoniae). The main reason for the consultation was the selection of antibiotics for drug-resistant bacteria infection;the following reason was the selection of antibiotics for mixed bacterial infection. The consultation advices of clinical pharmacists were mostly addition or replacement of antibiotics,followed by continuing the current treatment. Totally 37 cases were recovered from the hospital after receiving 40 times of consultation and adjusting medical orders. Before consultation,antibiotics with high utilization rate were piperacillin/tazobactam(11 cases)and roxavidospora(9 cases). After consultation,antibiotics with high utilization rate were vancomycin(8 cases)and amikacin(7 cases). CONCLUSIONS:Clinical pharmacists participate in pharmaceutical consultation of urinary tract infection in children,provide suggestions and adjust therapy plan from aspect of pharmacy to promote rational use of antibiotics and therapy efficacy.