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To explore the prescription rationality of compound dextromethorphan hydrobromide syrup and the review effectiveness of the rational drug use system in pediatric outpatient and emergency departments, clarify the key medication risk points and system shortcomings, and provide data support and practical evidence for optimizing the safety prevention and control process of pediatric medication.
A retrospective study was conducted to collect prescriptions of compound dextromethorphan hydrobromide syrup in the outpatient and emergency departments of our hospital from January to December 2024. The mode of system screening combined with manual review was adopted, and an age-weight dual-dimensional evaluation criteria was established with reference to drug instructions and relevant clinical guidelines. The irrational prescriptions were classified and analyzed, and statistical analysis was performed using Excel 2010 and SPSS 23.0 software.
A total of 74 905 prescriptions of this preparation were issued throughout the year. System screening identified 527 positive irrational prescriptions, among which 357 were confirmed as true positive irrational prescriptions after manual review, with a system precision rate of 67.74% (357 prescriptions /527 prescriptions) and a false positive rate of 32.26% (170 prescriptions /527 prescriptions), and the overall irrational prescription rate was 0.48% (357 prescriptions /74 905 prescriptions). The core issues of irrational prescriptions primarily include drug interactions, duplicate medication, inappropriate dosage and administration, and unsuitable indications, accounting for 29.41% (105 prescriptions/357 prescriptions), 26.05% (93 prescriptions /357 prescriptions), 29.41% (105 prescriptions /357 prescriptions) and 16.81% (60 prescriptions /357 prescriptions), respectively. 98.24% (167 prescriptions /170 prescriptions) of false positive prescriptions were from overweight patients, indicating defects in the single-dimensional judgment logic of the system; the true positive rate of nighttime prescriptions 75.56% (250 prescriptions /357 prescriptions) was higher than 65.05% (255 prescriptions/392 prescriptions) of daytime prescriptions.
The medication risks of compound dextromethorphan hydrobromide syrup in children are characterized by age concentration and vary among different age groups, and the rational drug use system has efficiency shortcomings. It is necessary to optimize the age-weight dual-dimensional judgment system, implement hierarchical prevention and control, source intervention and system upgrading, so as to effectively improve the level of pediatric medication safety, and provide reference for the clinical standardized management of this preparation and the optimization of rational drug use system.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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