摘要
目的 了解大环内酯类药物在慢性鼻窦炎(CRS)治疗中的使用现状,探讨大环内酯类药物用于CRS的合理性和安全性.方法 对中国耳鼻喉科医师开展问卷调查,评估为CRS患者处方大环内酯类药物的态度、处方习惯和安全性担忧.结果 共回收问卷478份,有效回收率为100.0％.受访者中,"有时""经常"和"偶尔"为CRS患者处方大环内酯类药物占比分别为38.7％、31.0％和20.1％;药物种类以克拉霉素为主,其次是罗红霉素;使用剂量通常以常规剂量为主;约97.7％的医师会选择较短的疗程(3个月内),更多倾向于2～4周和1～2周;受访者处方大环内酯类药物前从未进行过血常规、IgE水平、过敏原和药敏试验检测比例分别为42.7％、17.8％、45.8％和 37.4％;41.4％的受访者从未关注大环内酯类药物与其他药物的相互作用;对于特殊人群,1.5％、4.2％和 47.9％的受访者会为CRS伴妊娠、哺乳期及儿童患者处方大环内酯类药物.结论 大多数耳鼻喉科医师基本遵循国内外相关指南使用大环内酯类药物,但在适用人群、剂量和疗程方面仍有差距,同时应加强对联合用药的关注度,以降低严重不良事件的发生风险.
Abstract
Objective To understand the current status of macrolides used in the treatment of chronic rhinosinusitis(CRS),and to provide a basis for the rationality and safety of macrolides for CRS.Methods A questionnaire survey was conducted among Chinese otolaryngologists to assess attitudes,prescribing habits,and safety concerns about prescribing macrolides to patients with CRS.Results A total of 478 questionnaires were returned,with a validity rate of 100.0％.Most of the respondents believed that they would prescribe macrolides to patients with CRS when necessary,and"Sometimes","often"and"infrequently"prescribed macrolides 38.7％,31.0％,and 20.1％,respectively.Clarithromycin dominated,and was followed by roxithromycin,they were usually given in regular dosage,and about 97.7％of the otolaryngologists opted for a shorter course of treatment(less than 3 months),with a greater tendency to prefer 2 to 4 weeks and 1 to 2 weeks.42.7％,17.8％,45.8％,and 37.4％of the respondents had never undergone blood routine tests,IgE level tests,allergen,and drug sensitivity tests before prescribing macrolides,respectively.41.4％of the respondents had never paid attention to the interactions of macrolides with other drugs;for special populations,1.5％,4.2％,and 47.9％of respondents prescribed macrolides for chronic CRS patients during pregnancy,lactation,and children.Conclusion Most otolaryngologists follow relevant domestic and international guidelines to use macrolides,but there are still gaps in the applicable population,dosage,and course of treatment.At the same time,more attention should be paid to the combination of drugs to reduce the risk of serious adverse events.
基金项目
首都卫生发展科研专项基金(首发2020-1-2051)
首都医科大学附属北京同仁医院基金(2021-YJJ-PY-013)
NETL
NSTL
万方数据