膀胱洗浄用液剤の使用実態と傾向

Abstract

1983年7月～11月の間に, 国内592病院の薬局, 診療科に対し膀胱洗浄用液剤の使用状況につき調査表を送付し集計した.今回の調査では, 病院薬局, 診療科での膀胱洗浄剤の種類, 使用量, 抗生物質の使用状況などにつき主としておこなったが, 全体とし膀胱洗浄剤についての考え方は, まちまちのようで必ずしも同じ方向性をもった考えではないようであった.今後院内感染の問題, 使用器具, 薬剤の種類・濃度, 血中への移行, 安全性などを含めた検討が望まれる

Questionnaires were sent to pharmacies and clinics in 592 Japanese hospitals from July to November, 1983 to investigate the use of bladder irrigation. The questionnaires were completed and returned by 418 hospitals, the rate of response being 70.8%. Fifty eight kinds of irrigants were prepared in hospital pharmacies and were reported to have been used in 1, 171 patients. Of these irrigants, chlorhexidine gluconate accounted for 18.8%, Polymyxin B for 17.1%, normal saline for 13.3%, potassium permanganate for 6.9%, and boric acid for 5.7%. Chlorhexidine gluconate was usually used at a concentration of 0.02% (in 79% of the total use of the agent), Polymyxin B at 0.01%, 0.02% and 0.05%, potassium permanganate at 0.01% and 0.02% (in 73% of the total use), and acrinol at 0.01%, 0.05% and 0.1%. To questions about side effects, such as irritation, 65 hospitals answered that irritation had occurred. Irrigants were most frequently supplied to non-disposable 500 ml containers used exclusively for this purpose, 38% of all the hospitals using this method. Non-disposable 1 liter containers for exclusive use with bladder irrigants were used in 23% of the hospitals. Purified water was most frequently used to prepare the bladder irrigants (in 35% of hospitals) followed in descending order, by sterile purified water in 33%, and distilled water for injection in 26%. Water for irrigants was prepared at the hospital in 83% of the hospitals. The time of storage of the prepared bladder irrigants was mostly one week to one month, and was within one month in 78% of the hospitals. Seventeen percent of the hospitals answered that the preparation of bladder irrigants was a cause of overwork in their pharmacies. Irrigants against Pseudomonas infections were prepared separately in 40% of the hospitals, and there was no such regulation in 37%. Forty four agents were used to prepare such irrigants, and Polymyxin B accounted for 50%. The use of these agents significantly (P less than 0.001) differed between hospitals. Forty eight percent of the hospitals made special preparations for patients with clouded urine, and there was no such regulation in 46%. Thirty nine agents were used for this purpose. Polymyxin B was used in 30%, and chlorhexidine gluconate in 19%. The use of these agents differed significantly (P less than 0.001) between hospitals.(ABSTRACT TRUNCATED AT 400 WORDS)