2023 年第 4 期 第 18 卷

奈玛特韦片/利托那韦片治疗新型冠状病毒感染的临床应用情况及合理性分析

Clinical application and rationality analysis of nirmatrelvir tablets/ritonavir tablets on the treatment of novel coronavirus infection

作者：周洋1张琳2魏娟娟1彭文星1石秀锦1林阳1

英文作者：Zhou Yang1， Zhang Lin2， Wei Juanjuan1， Peng Wenxing1， Shi Xiujin1， Lin Yang1

单位：1首都医科大学附属北京安贞医院药事部，北京100029；2天津医科大学总医院药剂科，天津300052

英文单位：1Department of Pharmacy Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Department of Pharmacy Tianjin Medical University General Hospital Tianjin 300052 China

关键词：新型冠状病毒感染；奈玛特韦片/利托那韦片；处方合理性

英文关键词：Novelcoronavirusinfection;Nirmatrelvirtablets/ritonavirtablets;Rationalityofprescription

• 摘要：

• 目的 分析奈玛特韦片/利托那韦片治疗新型冠状病毒感染的临床应用情况及合理性。方法 收集2022年12月9日至2023年1月16日首都医科大学附属北京安贞医院奈玛特韦片/利托那韦片的门急诊处方及住院医嘱，分析该药的临床使用情况。药师于2023年1月5日开展奈玛特韦片/利托那韦片处方或医嘱药学会诊，比较药师会诊前后用药合理情况。结果 共收集429例患者的奈玛特韦片/利托那韦片处方或医嘱，使用该药前3名的科室为感染科、急诊科、呼吸内科，其中感染科处方占总处方数的52.0%（223/429）；合并用药患者信息191例，主要涉及调脂、抗栓、降压、平喘化痰、降糖等药物。不合理处方或医嘱占30.5%（131/429），不合理原因主要为适应证不适宜［11.4%（49/429）］和用法用量不适宜［24.9%（107/429）］。药师会诊后该药处方合理率与给药剂量的合理率均明显提高［90.0%（63/70）比65.5%（235/359）、94.3%（66/70）比71.9%（258/359），均P＜0.001］。结论 奈玛特韦片/利托那韦片使用较多的科室为感染科、急诊科和呼吸内科。药物使用早期存在较多不合理情况，药师开展会诊后有效地提高了该药使用的合理性，保障了患者用药安全。

• Objective To analyze the clinical application and rationality of nirmatrelvir tablets/ritonavir tablets on the treatment of novel coronavirus infection. Methods From December 9, 2022 to January 16, 2023, outpatient and emergency prescriptions and inpatient medical orders of nirmatrelvir tablets/ritonavir tablets in Beijing Anzhen Hospital， Capital Medical University were collected to analyze the clinical use of the drug. On January 5, 2023, the pharmacists carried out a pharmaceutical consultation on the prescriptions or medical orders of nirmatrelvir tablets/ritonavir tablets to compare the rationality of the medication before and after pharmacists′ intervention. Results A total of 429 prescriptions or medical orders were retrieved, the top 3 departments using the drug were departments of infection, emergency and respiratory medicine, and the prescriptions of department of infection accounted for 52.0%(223/429) of the total prescriptions. There were 191 cases of information on patients with concomitant medication, mainly involving drugs such as lipid regulation, antithrombotic, antihypertensive, asthmatic and phlegm, and hypoglycemic. Unreasonable prescriptions or medical orders accounted for 30.5%(131/429), and the main reasons for irrationality were inappropriate indications ［11.4% (49/429)］ and inappropriate usage and dosage ［24.9%(107/429)］. After pharmacists′ intervention, the rational rate of prescription and dosage of the drug were significantly improved ［90.0%(63/70) vs 65.5%(235/359), 94.3%(66/70) vs 71.9%(258/359), both P<0.001］. Conclusions  Nirmatrelvir tablets/ritonavir tablets are commonly used in departments of infection, emergency and respiratory medicine. There are many unreasonable situations in the early stage of drug use. After pharmacists′ consultation and intervention, the rationality of drug use has been effectively improved, ensuring the safety of the patient medication.