Sedative-hypnotic drugs (SHDs) carry significant risks of misuse and dependence. However, current institutional pharmacovigilance relies heavily on passive reporting, leading to substantial underreporting and data gaps. This study aimed to develop and conduct a pilot evaluation of an electronic trigger-based active surveillance model integrated into a Hospital Information System (HIS) to proactively identify high-risk prescription patterns and suspected SHD dependence. This two-phase study was conducted at a tertiary hospital. First, a retrospective analysis of 16,609 outpatient prescriptions was performed to characterize anomalous utilization. Second, a "Trigger Dictionary" based on the Global Trigger Tool (GTT) was developed to flag suspicious cases for a 10-day prospective pilot evaluation. Patients with suspected dependence were screened through structured telephone interviews using ICD-10 diagnostic criteria among flagged patients with ≥ 1-year SHD use. Retrospective analysis revealed that 30.03% of patients (2,616/8,710) received at least one off-label prescription. It also identified 1,567 clusters in which multiple patient IDs shared identical residential addresses, serving as a potential, hypothesis-generating signal for drug diversion. During the prospective pilot, the system generated 200 automated alerts. Among the 63 high-risk patients interviewed, 17 were identified as meeting the screening criteria for suspected SHD dependence, yielding a Positive Predictive Value (PPV) of 26.98% within this selected high-risk interviewed cohort. In contrast, zero cases were reported via the passive system during the same period. Univariate analysis identified benzodiazepine use (OR 33.07, 95% CI: 3.95-276.81, P < 0.001), advanced age, and prolonged therapy duration as exploratory factors associated with suspected misuse. This 10-day prospective pilot evaluation suggests that the electronic trigger model can identify cases of suspected drug dependence that were not captured by traditional passive reporting during the same period. This automated framework offers a scalable approach for clinical pharmacists to triage high-risk patients and mitigate potential drug diversion risks, potentially enhancing medication safety in high-volume outpatient settings.

Pancreatic cancer (PC) is one of the most insidious malignant tumors with aggressive metastasis and ineffective treatments. Although gemcitabine (GEM) is the gold standard for PC, the acquired resistance and severe myelosuppression limit clinical utility. It has been found that abnormal aerobic glycolysis may be responsible for drug resistance in PC. Disulfiram (DSF), a commonly used anti-alcoholic drug, possesses potent anti-tumor activity combined with copper. Nevertheless, poor water solubility and neurotoxicity restrict clinical applications. Therefore, our group modified the structure of DSF and synthesized a novel compound CPD12C15, which exhibited stronger anti-tumor activity and lower neurotoxicity than DSF. Nanoparticles with excellent release properties, modified with hyaluronic acid (HA) targeting CD44, which is highly expressed on pancreatic cells, can evade the removal of natural defense system and enhance tumor-targeting ability. Herein, CPD12C15 was loaded into HA-modified PLGA nanoparticles (HPC-NP) in order to improve the sustained release properties and active targeting ability. Our research revealed that CPD12C15 combined with Cu (HPC-NP/Cu) could inhibit tumor proliferation, migration, invasion and induce apoptosis by suppressing the aerobic glycolysis pathway, which further inhibited cell stemness and drug resistance in vivo and in vitro, suggesting that it may be a potential strategy for PC treatment.

The misuse of benzodiazepines (BZDs) and Z-drugs poses significant global public health challenges. This study maps the scientific evolution and paradigm shifts in this field from 2010 to 2025. A bibliometric analysis of 6,311 publications from the Web of Science Core Collection was performed using VOSviewer and CiteSpace to identify collaboration networks, research hotspots, and emerging frontiers. The USA and Harvard Medical School dominated global contributions. Research hotspots evolved through three distinct phases: (1) 2010–2014 focused on GABAA receptor subtype-specific pharmacology, specifically the role of the alpha1 subunit in midbrain disinhibition and the biological basis of addiction; (2) 2015–2019 shifted toward the pharmacodynamic synergy of BZD-opioid interactions and the implementation of mass spectrometry-based toxicological surveillance; and (3) 2020–2025 centered on integrated computational pharmacology (QSAR and docking) for designer BZDs, alongside digital governance using electronic health records (EHR) and machine learning for precision deprescribing. Burst detection reveals a trajectory shifting from retrospective mechanistic deconstruction to prospective, data-driven risk prediction. BZD research has undergone a paradigm shift from molecular pharmacology to multidimensional digital and computational surveillance. Future directions prioritize utilizing big data and in silico modeling for individualized risk forecasting and precision clinical intervention to address the complex landscape of designer analogs and improve public mental health governance.

A systematic review was performed to assess the economic evaluation of sodium glucose transporters 2 (SGLT2) inhibitors vs GLP-1 receptor agonists (GLP-1RA) in treating type 2 diabetes. The relevant studies were searched in PubMed, Web of Science, Scopus, Embase, and Cochrane from the inception date to February 20, 2025. The titles, abstracts, and full texts were independently evaluated and screened by two authors. Additionally, the economic evaluation studies were assessed independently by two authors. 18 studies were included, evaluating oral semaglutide vs empagliflozin (n = 7), both oral semaglutide vs empagliflozin and subcutaneous semaglutide vs canagliflozin (n = 1), subcutaneous semaglutide vs empagliflozin (n = 4), liraglutide vs empagliflozin (n = 4), liraglutide vs dapagliflozin (n = 1), and subcutaneous semaglutide vs canagliflozin (n = 1). The results showed that when patients were assumed to receive initial therapies until HbA1c exceeded the target level and then treatment was intensified to basal insulin, GLP-1RA was cost-effective compared to SGLT2 inhibitors (semaglutide vs empagliflozin and liraglutide vs dapagliflozin). Empagliflozin demonstrated cost-effectiveness when the treatment with either empagliflozin or semaglutide would have continued indefinitely. Compared with empagliflozin, liraglutide may not be a cost-effective treatment option for patients with T2D who were not well-controlled with metformin.

The management of type 2 diabetes not only requires effective medications to regulate blood glucose levels, but also needs to consider the economic implications. Liraglutide, dulaglutide, and semaglutide, three widely-used glucagon-like peptide-1 receptor agonists, have shown significant efficacy in diabetes treatment. This review aimed to systematically assess the cost-effectiveness of liraglutide in comparison to dulaglutide or oral semaglutide for treating type 2 diabetes. A comprehensive literature search was performed in PubMed, Web of Science, Scopus, Embase, and Cochrane. Studies published up to December 31, 2024 were retrieved. Two independent reviewers carefully screened the titles, abstracts, and full-text articles, and any disagreements were resolved with the involvement of a third reviewer. Data extraction was carried out following a pre-designed form. 12 studies were included, evaluating liraglutide vs. dulaglutide (n = 8) and liraglutide vs. oral semaglutide (n = 6). The minimum consolidated health economic evaluation reporting standards score for the studies was 0.75. The included studies exhibited similar results in cost-effective. Oral semaglutide would be more effective and cost-saving in the US, Netherlands, Spain, and the UK. According to the available studies, liraglutide vs. dulaglutide or oral semaglutide for the treatment of type 2 diabetes is considered not to be cost-effective. Cost-effectiveness also plays a vital role in the inclusion of these drugs in healthcare reimbursement policies. The literature suggested that dulaglutide or oral semaglutide may be more cost-effective than liraglutide.

AIMS:The study aimed to analyse the cost-utility of Chinese patent medicine Qili Qiangxin (QLQX) capsules in heart failure with a reduced ejection fraction from the healthcare payer's perspective. METHODS AND RESULTS:From the perspective of the healthcare payer, a Markov model was established to estimate the cost-utility of adding QLQX capsules to standard treatment versus standard treatment. A 19-year lifetime horizon was chosen with a 3-month cycle in the base case analysis. The discount rate of cost and utility is 5%. Total costs and quality-adjusted life years (QALYs) for QLQX and standard treatment were simulated over a 19-year lifetime horizon by the Markov model using TreeAge Pro 2022. The incremental cost-utility ratio (ICUR) was compared with the willingness-to-pay thresholds (the GDP per capita). The one-way sensitivity analysis and probability sensitivity analysis were conducted. Over a 19-year lifetime horizon, the mean total costs in the QLQX group and standard treatment group were 56 151.75 CNY and 30 099.69 CNY, respectively. The QALYs in the QLQX group were also greater than those in the standard treatment group (4.63 QALYs vs. 4.17 QALYs). The ICUR was 57 381.85 CNY per QALY, which was lower than the willingness-to-pay threshold (89 358 CNY). The one-way and probability sensitivity analyses showed that the results were robust. The inputs with the largest impact on ICUR were the cardiovascular mortality in both groups. At a willingness-to-pay threshold of 89 358 CNY, adding QLQX capsules to standard treatment was preferred over standard treatment alone in 51.10% of the 1000 PSA samples. CONCLUSIONS:This cost-utility analysis suggested that adding QLQX capsules seems to be cost-effective of heart failure with a reduced ejection fraction patients from the healthcare payer's perspective in China. Future studies of QLQX capsules based on different economic systems and medical environments were also needed.

ObjectiveThis study evaluates and compares the effectiveness and safety of febuxostat and allopurinol in chronic kidney disease (CKD) stages 3-5 patients with asymptomatic hyperuricemia using a network meta-analysis.MethodsA systematic review and network meta-analysis were conducted, adhering to PRISMA-NMA guidelines. Searches included PubMed, Embase, Cochrane Library, and Chinese databases up to June 2024. Randomized controlled trials (RCTs) and cohort studies were assessed for methodological rigor using GRADE.ResultsA total of 12 RCTs and 4 cohort studies (n = 2,423 participants) were included. Febuxostat was associated with greater improvements in estimated glomerular filtration rate compared to allopurinol (MD, 4.99 mL/min/1.73 m2; 95%CI -0.65 to 10.78; certainty: low) and placebo (MD, 4.72 mL/min/1.73 m2; 95%CI 0.67 to 8.82; low). Serum uric acid reduction was also more pronounced with febuxostat (MD, -0.61 mg/dL; 95%CI -1.15 to -0.05; moderate). Safety outcomes, including major cardiovascular events and adverse events, showed no significant differences between febuxostat and allopurinol. Subgroup analyses revealed enhanced effectiveness of febuxostat at six months of treatment.ConclusionsThis analysis provides robust evidence that febuxostat might offers greater improvements in kidney function and uric acid levels compared to allopurinol or placebo in asymptomatic hyperuricemia with CKD stage 3-5 patients, without compromising safety. These findings can guide clinical decision-making and treatment optimization.

BACKGROUND:Adverse events (AE) in dupilumab-induced ocular surface diseases (DIOSD) have raised concerns regarding its safety. The objective of this study was to evaluate DIOSD by employing database analysis and clinical case review, along with mechanism analysis. RESEARCH DESIGN AND METHODS:Database AE data were extracted from FAERS from 2017 Quarter 1 (Q1) to 2023 Q1. Disproportionality analyses were performed to identify the risk signals associated with DIOSD. Case reports/case series reported on DIOSD from March 2017 to June 2023 were collected for a literature review. The mechanisms of DIOSD were investigated through disease-gene interaction network analysis. RESULTS:A total of 85 signals related to DIOSD were detected from FAERS. The most reported AE was 'dry eye' (n = 3503, ROR 20.32, 95% CI: 19.53-21.14). There were 36 articles, including 201 cases showing the evidence of DIOSD, with an average age of 43 years. About 64.18% patients suffered from severe atopic dermatitis, and 48.26% were reported with a previous ocular history. The mechanisms study suggested that tumor necrosis factor plays an important role in DIOSD. CONCLUSIONS:Our findings support that dupilumab use is associated with exacerbation or new-onset OSD. Particular attention should be focused on eye symptoms during dupilumab use.

IntroductionChronic kidney disease is a significant public health issue. Dapagliflozin has been shown to improve the quality of life for patients with chronic kidney disease. This review aimed to systematically assess the cost-effectiveness of adding dapagliflozin to standard care compared with standard care alone for treating chronic kidney disease.MethodsThe relevant studies were searched in PubMed, Web of Science, Scopus, Embase, and Cochrane from the inception date to June 1, 2024. The titles, abstracts, and full texts were independently evaluated and screened by two authors. Additionally, the economic evaluation studies were assessed independently by two authors using the consolidated health economic evaluation reporting standards checklist.Results14 studies were included which were about the economic evaluations of adding dapagliflozin in the treatment of chronic kidney disease. The minimum consolidated health economic evaluation reporting standards score for the studies was 0.77, indicating very good quality. Adding dapagliflozin to the standard of care would be more effective and cost-saving in Mexico, Malaysia, Canada, Thailand, and China. The highest incremental cost-effectiveness ratio of dapagliflozin ($67962.75/QALY) originated from the USA. According to the available studies, adding dapagliflozin to standard of care for the treatment of chronic kidney disease is considered cost-effectiveness from both the healthcare system and the payer's perspective.ConclusionAdding dapagliflozin to standard care in the treatment of chronic kidney disease is cost-effective from both the healthcare system and the payer's perspective in well-developed countries.

Chemotherapy proves to be a successful method in treating primary breast cancer. Ironically, some commonly used chemotherapeutics may promote lung metastasis by increasing the activity of activating transcription factor 3 (ATF3). Thus, it is necessary to inhibit tumor metastasis while improving the anti-tumor effect of anti-cancer drugs. Herein, using curcumol (CUR) that possesses both anti-tumor and anti-metastasis activities as a model drug, we designed the nanogels based on temperature-responsive self-assembly and glutathione-triggered disassembly to address the abovementioned conflicts. Briefly, the copolymers (H-SS-P) were synthesized by coupling poly(N-isopropylacrylamide) onto hyaluronic acid (HA) via a disulfide bond-containing linker cystamine dihydrochloride. Copolymers could self-assemble into regular spherical nanogels at 37 °C with a 40-nm particle size for PNIPAAm's thermosensitivity. Hydrophobic CUR could be automatically entrapped into the core of nanogels. The H-SS-P@CUR nanogels could release drugs quickly upon exposure to the reductive tumor microenvironment. The superior efficacy of H-SS-P@CUR on inhibiting tumor growth was validated through assays both in vivo and in vitro. Moreover, nanogels may better down-regulate the expression of ATF3 protein by enhancing the cell uptake and tumor targeting of CUR, thereby significantly improving the anti-metastasis effect of CUR. This work not only proposed a novel strategy to simplify the preparation process of nanogels but also achieved effective drug delivery with enhanced anti-cancer and anti-metastasis effects.

BACKGROUND:To detect and analyze risk signals of the drug-related adverse events (AEs) of 4 gadolinium-based contrast agents (GBCAs) (gadopentetate dimeglumine (Gd-DTPA), gadobenate dimeglumine (Gd-BOPTA), gadoteridol (Gd-HP-DO3A), and gadobutrol (Gd-BT-DO3A)) according to the US Food and Drug Administration Adverse Event Reporting System (FAERS) database and ensure the clinical safety.RESEARCH DESIGN AND METHODS:The AEs that are associated with the 4 GBCAs were collected from the FAERS database from 2004Q1 to 2022Q3. The risk signals were mined using reporting odds ratio (ROR) and proportional reporting ratio (PRR).RESULTS:424 risk signals were excavated, in which 151 risk signals were associated with Gd-DTPA, 93 risk signals were related to Gd-BOPTA, 79 risk signals were relevant to Gd-HP-DO3A, and 101 risk signals were associated with Gd-BT-DO3A. The AE signals involved 20 system organ classes (SOCs). Two of the top four SOCs were identical, namely 'skin and subcutaneous tissue disorders' and 'general disorders and administration site conditions.'CONCLUSIONS:The safety signals of 4 GBCAs were detected, and the SOCs associated with the AEs of the 4 GBCAs were different. Besides, some AEs obtained in this study were not mentioned in the package inserts, which need more attention and research to ensure the clinical safety.

Background The sharp increase in fungal infections, insufficient diagnostic and treatment capabilities for fungal infections, poor prognosis of patients with fungal infections as well as the increasing drug resistance of fungi are serious clinical problems. It is necessary to explore the implementation and evaluation methods of antifungal stewardship (AFS) to promote the standardized use of antifungal drugs. Methods The AFS programme was implemented at a tertiary first-class hospital in China using a plan-do-check-act (PDCA) quality management tool. A baseline investigation was carried out to determine the utilization of antifungal drugs in pilot hospitals, analyse the existing problems and causes, and propose corresponding solutions. The AFS programme was proposed and implemented beginning in 2021, and included various aspects, such as team building, establishment of regulations, information construction, prescription review and professional training. The management effectiveness was recorded from multiple perspectives, such as the consumption of antifungal drugs, the microbial inspection rate of clinical specimens, and the proportion of rational prescriptions. The PDCA management concept was used for continuous improvement to achieve closed-loop management. Results In the first year after the implementation of the AFS programme, the consumption cost, use intensity and utilization rate of antifungal drugs decreased significantly (P < 0.01). The proportion of rational antifungal drug prescriptions markedly increased, with the proportion of prescriptions with indications increasing from 86.4% in 2019 to 97.0% in 2022, and the proportion of prescriptions with appropriate usage and dosage increased from 51.9 to 87.1%. In addition, after the implementation of the AFS programme, physicians' awareness of the need to complete microbial examinations improved, and the number of fungal cultures and serological examinations increased substantially. Statistics from drug susceptibility tests revealed a decrease in the resistance rate of Candida to fluconazole. Conclusion This study indicated that the combination of AFS and the PDCA cycle could effectively reduce antifungal consumption and promote the rational use of antifungal drugs, providing a reference for other health care systems to reduce the overuse of antifungal drugs and delay the progression of fungal resistance.

Purpose: To assess the quality of clinical practice guidelines (CPGs) related to drug therapy for prevention and control of ventilator-associated pneumonia (VAP) and compare the differences and similarities between recommendations. Methods: Electronic databases (including PubMed, Cochrane library, Embase, Web of Science), guideline development organizations, and professional societies were searched to identify CPGs for VAP from 20 January 2012 to 20 January 2022. The Appraisal of Guidelines Research & Evaluation (AGREE) II instrument was used to evaluate the quality of the guidelines. The recommendations on drug therapy for prevention and treatment for each guideline were extracted, and then a descriptive synthesis was performed to analyze the scope/topic, and consistency of the recommendations. Results: Thirteen CPGs were included. The median score and interquartile range (IQR) in each domain are shown below: scope and purpose 72.22% (63.89%,83.33%); stakeholder involvement 44.44% (38.89%,52.78%); rigor of development 43.75% (31.25%,57.29%); clarity and presentation 94.44% (77.78%,94.44%); applicability 20.83 (8.34%,33.34%) and editorial independence 50% (33.33%,66.67%). We extracted 21 recommendations on drug therapy for prevention of VAP and 51 recommendations on drugs used for treatment. Some controversies remained among the included guidelines. Conclusion: There is considerable variability in the development processes and reporting of VAP guidelines. Despite many similarities, the recommendations still had some inconsistencies in the details. For the prevention and treatment of VAP, local microbial epidemiology and antibiotic sensitivity must be considered, and recommendations should be regularly revised as new evidence emerges.

Ulinastatin (UTI), a broad-spectrum elastase inhibitor, can stabilize lysosomal membranes and inhibit the activation and release of various inflammatory cytokines caused by cardiopulmonary bypass (CPB).[1,2] UTI has recently been considered to be an effective anti-inflammatory agent and has been widely used in clinical settings,[3–5] but the optimal dose has not been defined. Therefore, we conducted a prospective, randomized, controlled trial involving 60 patients undergoing cardiac surgeries with CPB and investigated the serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8), at different time points in order to evaluate the anti-inflammatory efficacy of high-dose UTI and explore the optimum dose. The Ethical Committee of Yantai Yuhuangding Hospital approved this study (No. 2015F28). All patients signed informed consent forms before surgery. A total of 60 patients with cardiac diseases (26 with congenital heart diseases and 34 with valvular heart diseases) and scheduled for elective cardiac surgery under CPB in Yantai Yuhuangding Hospital between June 1, 2016 and July 31, 2017 were enrolled in our study with a mean age of 52.3 ± 9.7 years. The patients were randomly divided into four groups according to a random number table: U1, U2, U3, and control group, with 15 patients in each group. In the first three groups, 20,000 IU/kg (U1 group), 40,000 IU/kg (U2 group) and 60,000 IU/kg (U3 group) UTI (Guangdong Techpool Bio-pharma Co., Ltd, Guangzhou, Guangdong, China), respectively, was diluted in 20 mL saline, which was added to the pre-filling liquid after the initiation of anesthesia. The last group received 100,000 IU of UTI, which was added to the pre-filling liquid, and 100,000 IU of UTI intravenously every 8 h for 2 days following the operation. The serum levels of TNF-α, IL-6, and IL-8 were measured using ELISA kits (Shanghai QiaoDu Biotechnology Co., Ltd., Shanghai, China) the day before surgery (T0), 30 min after aortic occlusion (T1), 1 h after aortic occlusion (T2), the moment of weaning from CPB (T3), and 6 h (T4), 12 h (T5), 24 h (T6) and 48 h (T7) after weaning from CPB. The data were processed by SPSS 21.0 (SPSS Inc., Chicago, IL, USA) for statistical analysis. All the normally distributed variables were expressed as the mean ± standard deviation. Analysis of variance was used for comparisons between the groups followed by least significant difference (LSD) or Games-Howell test for multiple comparisons, and the serial variables were compared using analysis of variance for repeated measures. Differences were considered statistically significant when the values of P were less than 0.05. The four groups were similar with respect to demographic data including age, gender, and body weight (P > 0.05). There was no significant difference in operation time, CPB time, and aortic cross-clamping time among four groups (P > 0.05). The comparisons of TNF-α, IL-6, and IL-8 levels are shown in Table 1. The results showed that TNF-α levels were increased from T1, and peaked at T4 in control group, group U1 and group U2, and at T5 in group U3, and the differences were statistically significant among groups from T1-T7 (all P < 0.001). TNF-α levels were still higher until T7 compared with basic levels in all groups, but statistical differences were found only in group U1, U2, and control groups (all P < 0.05). IL-6 levels reached the peak at T3 in control group, at T4 in group U1 and U3, and at T5 in group U2, and the differences were statistically significant among groups from T1-T7 (all P < 0.001). And IL-6 levels were still higher than the basic levels in control group, group U1 and group U2 with significant differences (all P < 0.05). IL-8 levels were increased from T1 significantly and peaked at T3 in group U1, T4 in control group and group U3, and T5 in group U2, and the differences were statistically significant among groups from T1-T7 (all P < 0.001). And IL-8 levels were still higher than the basic levels until T7 in all groups with significant differences (all P < 0.05).Table 1: The serum levels of TNF-α, IL-6, and IL-8 of patients undergoing open-heart surgery under CPB with different doses of UTI (ng/L).The results showed that the serum levels of the inflammatory cytokines increased postoperatively in all of the groups, indicating that the surgical procedure resulted in the activation of inflammatory cytokines. Comparisons among the groups showed that the postoperative inflammatory cytokine levels in U3 group were significantly lower than those in the other three groups, indicating that UTI can partially reduce the levels of inflammatory cytokines and inhibit the postoperative inflammation in a dose-dependent manner. Our results also revealed that the effect of high-dose UTI was substantially superior to the clinical dose that is routinely used. The average total UTI dose for each patient in group U1 was higher than that of the control group; however, the results indicated that the inflammatory cytokine levels were higher in the U1 group than in the control group. The possible reason for these results could be that patients in the U1 group received their total dose of UTI intra-operatively, while patients in the control group received 100,000 IU of UTI intra-operatively and 100,000 IU of UTI intravenously every 8 h for 2 days following the operation. Additionally, we observed that the blood concentration of UTI obviously declined within 3 h of administration, which is likely due to its extremely short half-life. Although UTI was administered to the patients in group U2 and group U3 in the same manner as to those in group U1, the higher dose of UTI used in groups U2 and U3 resulted in higher blood concentrations and a better therapeutic effect compared with those in group U1. Therefore, different routes of UTI administration may restrict its effects. Further studies are needed to evaluate the most effective route of administering the total dose of UTI used in this study. Funding This study was supported by the grant from Science and Technology Development Plan of Yantai City (No. 2015WS033). Conflicts of interest None.

Objective To investigate the strategy of antimicrobial stewardship(AMS),and in order to improve the rationality of drug use and the diagnosis and treatment level of difficult and complicated infection. Methods The level of AMS was improved by using the laws and regulations of antimicrobial agents,and the effect of functional and administrative department and the mode of the multidisci-plinary team (MDT). Results All kinds of management indexes in our hospital met the requirement of laws and regulations. Some in-dexes such as the microbe inspection rate and the ratio of sterile specimen had exceeded the requirement. The drug resistance rate of glycopeptides and carbapenems declined year by year. The rates of clinical rationality of antibiotics for therapeutic,special use and drug-resistant bacteria were all over 98. 00%. Conclusion MDT can make up for the shortage of discipline and effectively improve the level of diagnosis and treatment of difficult and critical infections,AMS can be used to achieve scientific,standardized,fine,standard-ized management of antibacterial drugs.

Objective To evaluate the intervention effect of clinical pharmacists on the clinical application of antibiotics for special use. Methods Totally 200 cases of clinical data were collected from all inpatients with antibiotics for special use from January to June in 2015 (before intervention) and from January to June in 2016 (after intervention),respectively (elimination of medical records in ICU and Department of Pediatric Internal Medicine). The utilization rate and per capita cost of the drugs were compared,and the clini-cal rational drug use,the occurrence of adverse drug reactions,the prognosis of the disease and the preventive medication were statisti-cally analyzed. Results After intervention,the clinical application rationality and disease prognosis of antibiotics for special use were significantly improved compared with those before intervention,the utilization rate decreased from 12. 67％ to 7. 75％,the per capita cost decreased from 307. 94 Yuan to 178. 60 Yuan,and the rate of preventive medication decreased from 40. 50％ to 10. 00％(P < 0. 05). Conclusion The clinical pharmacists′ intervention on the application of antibiotics for special use can significantly reduce the indexes of application,it has significantly intervention effect,which can play a positive role for the safe,effective,economical and rational use of the drugs in clinic.