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ICU常用16种静脉用抗菌药物配伍稳定性研究
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          张俐婷    1, 2* ,杨浩天 ,于思奇 ,范理菊 ,安 静               1, 2, 3 # (1.河北医科大学药学院,石家庄 050017;2.河北省
                                               1, 2
          人民医院药学部,石家庄 050051;3.河北省临床药学重点实验室,石家庄 050051)
          中图分类号  R978.1      文献标志码  A      文章编号  1001-0408(2026)04-0468-08
          DOI  10.6039/j.issn.1001-0408.2026.04.10

          摘   要  目的  系统分析重症监护病房(ICU)常用抗菌药物的配伍稳定性,为临床合理用药提供循证依据。方法  收集河北省人
          民医院合理用药监测系统中 2024 年 1-12 月的 ICU 用药数据,向河北省内重症医学及药学专家进行咨询,结合药品说明书、
          Micromedex、Trissel’s Injectable Drug Handbook、PubMed等数据库中的药物相容性检索结果,筛选ICU常用抗菌药物及其他静脉
          药物,对药物组合的理化稳定性进行分析;同时,采用Cytoscape 3.10.2软件构建药物相容性网络互作图,对高风险药物进行识别。
          结果与结论  本研究共收集到ICU常用的16种抗菌药物及65种静脉药物的904个两两配伍的药物组合,其中549个组合(60.7%)
          相容,88个组合(9.7%)不相容,82个组合(9.1%)证据矛盾,185个组合(20.5%)证据缺失。不相容性风险较高的药物主要包括注
          射用两性霉素B、注射用头孢他啶、注射用亚胺培南西司他丁钠、注射用头孢曲松钠、注射用盐酸万古霉素等。药物间的不相容性
          风险因素主要包括药物浓度、温度、混合速度、pH及药物化学结构等。临床使用时,应依据具体药物的相容性数据,合理选择药物
          与溶媒,并加强对药物相容性的研究与监测。
          关键词  抗菌药物;静脉药物;配伍稳定性;相容性;重症监护病房

          Study on the compatibility stability of 16 commonly used intravenous antibiotics in ICU
          ZHANG Liting ,YANG Haotian ,YU Siqi ,FAN Liju ,AN Jing            1, 2, 3 (1.  School  of  Pharmacy,  Hebei
                                                                1, 2
                        1, 2
                                         2, 3
                                                    1, 2
          Medical  University,  Shijiazhuang  050017,  China;2.  Dept.  of  Pharmacy,  Hebei  General  Hospital,  Shijiazhuang
          050051, China;3. Hebei Provincial Key Laboratory of Clinical Pharmacy, Shijiazhuang 050051, China)
          ABSTRACT    OBJECTIVE  To  systematically  analyze  the  compatibility  stability  of  commonly  used  intravenous  antibiotics  in  the
          intensive care unit (ICU), and to provide evidence-based support for rational clinical drug use. METHODS  Medication data from
          the ICU of Hebei General Hospital between January and December 2024 were extracted from the Prescription Automatic Screening
          System.  Commonly  used  intravenous  antibiotics  and  other  intravenous  drugs  in  the  ICU  were  selected  through  consultations  with
          critical  care  and  pharmacy  experts  in  Hebei  province,  drug  package  inserts  and  compatibility  information  retrieved  from
          Micromedex, Trissel’s  Injectable  Drug  Handbook  and  PubMed. The  physicochemical  stability  of  drug  combinations  was  analyzed.
          In  addition,  Cytoscape  3.10.2  software  was  used  to  construct  a  drug  compatibility  network  for  identifying  high-risk  drugs.
          RESULTS  &  CONCLUSIONS  A  total  of  904  pairwise  drug  combinations  involving  16  antibacterial  agents  and  65  intravenous
          drugs  were  collected. Among  them,  549  combinations (60.7%)  were  compatible,  88  combinations (9.7%)  were  incompatible,  82
          combinations (9.1%)  had  conflicting  evidence,  and  185  combinations (20.5%)  lacked  valid  data  support.  High-risk  combination
          drugs  primarily  involved  Amphotericin  B  for  injection,  Ceftazidime  for  injection,  Imipenem-cilastatin  for  injection,  Ceftriaxone
          sodium  for  injection,  Vancomycin  hydrochloride  for  injection,  etc.  The  main  risk  factors  for  drug-drug  incompatibility  included
          drug  concentration,  temperature,  mixing  rate,  pH,  and  chemical  structure.  In  clinical  practice,  drugs  and  diluents  should  be
          selected  rationally  based  on  specific  compatibility  data,  and  research  and  monitoring  of  drug  compatibility  should  be  further
          strengthened.
          KEYWORDS     antibiotics; intravenous drugs; compatibility stability; compatibility; intensive care unit

              Δ 基金项目 河 北 省 医 学 科 学 研 究 课 题 计 划 资 助 项 目(No.
          20250307);吴阶平医学基金会临床科研专项资助基金(No.320.6750.               在重症监护病房(intensive care unit,ICU)中,患者
          2024-6-60)                                          因免疫功能受损、多器官功能衰竭或接受侵入性操作
             * 第一作者 硕 士 研 究 生 。 研 究 方 向 :临 床 药 学 。 E-mail:
                                                             (如机械通气、中心静脉导管置入)等因素,面临极高的
          zlt200100@163.com
                                                              感染风险,这使得脓毒症成为 ICU 常见且致命的并发
              # 通信作者 副主任药师,硕士生导师,博士。研究方向:临床药
          学。E-mail:anjingyaofen@163.com                       症。研究显示,脓毒症患者早期使用广谱抗菌药物可显


          · 468 ·    China Pharmacy  2026 Vol. 37  No. 4                               中国药房  2026年第37卷第4期
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