处方前置审核干预对Ⅰ类切口手术患者抗菌药物合理使用的影响

Effect of Prescription Pre-Review and Intervention on Rational Use of Antibacterial Drugs in Patients Undergoing Type I Incision Surgery

目的:评价处方前置审核干预对Ⅰ类切口手术患者抗菌药物合理使用的影响,为提高围术期患者抗菌药物预防用药水平提供参考。方法:选取处方前置审核系统与医院信息系统对接前后郑州大学附属郑州中心医院收治的行Ⅰ类切口手术的患者各300例,采集患者的性别、年龄、手术类型,以及抗菌药物的品种选择和用药疗程等;依据药品说明书、《抗菌药物临床应用指导原则(2015年版)》等权威资料,对患者的抗菌药物使用情况进行合理用药点评,分析处方前置审核干预对Ⅰ类切口手术患者抗菌药物合理使用的影响。结果:干预前后,2组患者在性别、年龄和手术类型方面经比较其差异无统计学意义(P>0.05);干预后患者的抗菌药物预防性使用率低于干预前(21.33%vs 29.67%,P<0.05);干预后患者围术期抗菌药物的品种选择合理率高于干预前(98.44%vs 88.76%,P<0.05);干预后患者抗菌药物预防用药疗程的合理率高于干预前(81.25%vs 51.69%,P<0.05)。结论:处方前置审核干预从品种选择、用药疗程等方面提高了医院Ⅰ类切口手术患者的抗菌药物预防用药水平。

Objective:To evaluate the effect of prescription pre-review and intervention on rational use of antibacterial drugs in patients undergoing type I incision surgery,so as to provide reference for improving the prophylactic use of antibacterial drugs in perioperative patients.Methods:A total of 300 patients who underwent type I incision surgery in the Zhengzhou Central Hospital Affiliated to Zhengzhou University were chosen before and after the transfer between the prescription pre-review system and the hospital information system.The patients'information such as gender,age,type of surgery,selection of antibacterial drugs and the course of medication was collected.The rational use of antibacterial drugs in the patients was commented according to the authoritative materials such as package inserts of drugs and Guiding Principles for Clinical Application of Antibacterial Drugs(2015),and the effect of prescription pre-review and intervention on rational use of antibacterial drugs in patients undergoing type I incision surgery was investigated.Results:There were no significant differences in gender,age and type of surgery between the two groups of patients before and after intervention(P>0.05);the rate of prophylactic use of antibacterial drugs after intervention was lower than that before intervention(21.33%vs 29.67%,P<0.05);the reasonable rate of antibacterial drug selection in the perioperative period after intervention was higher than that before intervention(98.44%vs 88.76%,P<0.05);and the reasonable rate of the course of prophylactic medication of antibacterial drugs after intervention was higher than that before intervention(81.25%vs 51.69%,P<0.05).Conclusion:The prescription pre-review and intervention can improve the level of prophylactic use of antibacterial drugs in patients undergoing type I incision surgery in the hospital in terms of variety selection and medication course,etc.