重视围手术期抗菌药物合理应用

Importance of Rational Application of Antibiotics in Perioperative Time

目的 提高围手术期中抗菌药物预防使用的合理性。方法 1997年 3月和 2 0 0 1年 3月两组手术患者用药调查 ,比较围手术期预防性使用抗菌药物的情况。结果 通过加强围手术期预防用药的管理工作 ,制定可行的规章制度、定期监测和结果反馈、采取干预性措施等手段 ,促使围手术期抗菌药物应用的规范化、合理化 ;2 0 0 1年组手术前期抗菌药物使用率下降 (P <0 .0 0 1) ,手术期用药率提高 (P <0 .0 0 1) ,手术后期用药时间缩短 1～ 2 d;预防性用药种类趋向广谱抗菌药物 ,第三代头孢菌素类和氟喹诺酮类药物比例增高。结论 应严格掌握各类手术预防用药的指征 ;加强手术前期预防性用药的管理 ;选择适当抗菌药物进行围手术期的预防 ;限制手术后期用药时间 ;定期对手术患者用药进行监测。

OBJECTIVETo improve the rationality of the prophylactic application of antibiotics in perioperative time. METHODSThe data of medication of two groups of patients in Mar 1997 and Mar 2001 were collected respectively, and the condition of prophylactic application of antibiotics in perioperative time was compared. RESULTSBy means of reinforcing the management of prophylactic medication in perioperative time, formulating practicable regulations, supervising the feedback results, and conducting intervenient measures, the application of antibiotics in perioperative time was made more regularly and rationally. Iu comparison with that in Mar 1997 group the percentage of preoperative antibiotic medication in Mar 2001 group was lower P<0.001; the percentage of intraoperative medication was higher (P<0.001) and the duration of postoperative medication was 1-2 days shorter, and the percentage of postoperative medication was up to 100% same in the two groups. There was a trend using more broad-spectrum antimicrobials for prophylaxis, and the proportion using third-generation of cephalosporins and quinupristin antimicrobials was higher.CONCLUSIONSIn order to administrate antimicrobials rationally and to prevent the postoperative infections, the perioperative administration of antimicrobials for prophylaxis needs to reach a higher level, and the following measures need to be emphasized: to familiarize with the indication of prophylactic medication of various operations; to control preoperative prophylactic medication; to select proper antibiotics for perioperative prophylaxis; to limit the period of postoperative medication; to supervise the administration of antibiotics to the operated patients regularly.