2018年安徽医科大学附属阜阳医院Ⅰ类切口围手术期预防用抗菌药物的使用合理性分析

Analysis on reasonable use of prophylactic antibacterial drugs in perioperative period of type I incision in Affiliated Fuyang Hospital of Anhui Medical University in 2018

目的了解2018年安徽医科大学附属阜阳医院Ⅰ类切口围手术期预防用抗菌药物的使用情况,并分析评价其用药合理性。方法抽取安徽医科大学附属阜阳医院2018年1～9月Ⅰ类切口手术病历共600例,从适应症、品种选择、给药时机、用药疗程、用法用量、联合用药等方面进行分析。结果Ⅰ类切口围手术期使用抗菌药物的病例有279例,使用率为46.58%,使用品种有13种,第2代头孢菌素头孢呋辛钠的使用最多,构成比为62.63%;其中术前0.5～1 h用药251例,合理率89.96%。用药疗程<24 h的有223例(79.93%)。用法用量不适宜的有6例,其中美洛西林钠和头孢西丁钠均3例。联合用抗菌药物2例,占0.72%,均无联合用药指征。结论安徽医科大学附属阜阳医院Ⅰ类切口预防用抗菌药物存在不合理现象,需加强规范管理,促进抗菌药物的合理使用。

Objective To investigate the application of prophylactic antibacterial drugs in perioperative period of type I incision in Affiliated Fuyang Hospital of Anhui Medical University in 2018,and analyze and evaluate the rationality of drug use.Methods Medical records (600 cases) having surgery with type I incisions from January to September 2018 in Affiliated Fuyang Hospital of Anhui Medical University were selected,and indication,variety choice,administration time,course of treatment,usage and dosage,and combination of antibiotics were analyzed.Results There were 279 cases of perioperative use of antibiotics in patients with type I incisions,with the application rate of 46.58%.A total of 13 types of antibiotics were used,and most of them were second generation cephalosporin cefuroxime sodium,accounting for 62.63%.The antibiotics were used between 0.5-1 h before surgery in 251 cases with the application rate of 89.96%.The course of treatment of antibiotics was not more than 24 h in 223 cases (79.93%).There were 6 cases of inappropriate usage and dosage,and there were mezlocillin sodium (3 cases) and cefoxitin sodium (3 cases).There were 2 cases of combination of antibiotics (0.72%),and were no indication of combination therapy.Conclusion There is still existed unreasonable prophylactic application of antibiotics for type I incision,so it is necessary to further strengthen the management and continuously promote the rational use of antibiotics in the clinic.