口腔颌面外科住院患儿使用抗生素的现状调查

An analysis of the use of antibacterial drugs in pediatric in-patients in Department of Oral and Maxillofacial Surgery

目的:了解口腔颌面外科住院患儿抗生素的使用情况,为临床合理用药提供参考。方法:随机抽查上海交通大学医学院附属第九人民医院2005-2006年口腔颌面外科患儿住院病历102份,年龄为3个月～18岁。填写"抗生素使用情况调查表",调查内容包括患者性别、年龄、疾病诊断、用药情况、实验室检查、细菌培养及药物敏感试验等;分别统计每位住院患者的用药种类、用药时间、联合用药、住院全程更换抗生素种类、给药途径。分析小儿口腔颌面外科抗生素使用是否合理。结果:抗生素使用率为94.12%,其中单独用药、二联用药使用率分别为74.51%、19.61%,主要采用静脉给药,口服用药54例,无肌注给药;住院全程更换抗生素种类2种37例(36.27%),3种24例(23.53%),4种10例(9.80%);细菌培养2例(1.96%);使用抗生素时间≤3d25例(24.50%),3～7d49例(48.04%),>7d22例(21.57%)。使用频率高的是头孢菌素、林可酰胺与青霉素类。结论:抗生素合理使用是主流,但仍存在未掌握手术预防用药原则、临床标本采集送检率较低、药物使用方法不合理、抗生素更换频繁与用药起点太高等不合理现象。应采取病区合理化布局、术前加强儿童保健、合理使用抗生素等对策。

PURPOSE： To investigate the status of administration of antibiotics drugs for pediatric in-patients in the Department of Oral and Maxillofacial Surgery in our hospital and offer guides for rational use of antibiotics in clinical practice. METHODS： 102 medical records of children from 3 months to 18 years in the Department of Oral and Maxillofacial Surgery in our hospital from the year of 2005-2006 were selected randomly. They were required to fill in the questionnaire which included gender, age, diagnosis of diseases, situation of medicine, laboratory examination, bacterial culture and sensitivity test of medicine. Respective analysis was done over the aspects of the variation of antibiotics medication, duration of medication, drug combination, various choices of antibiotics during the treatment and the ways of administration. A conclusion was drawn of whether the administration of antibiotics was rational. RESULTS： The rate of antibiotics administration was 94.12%, and the rates of single drug and combined administration （two drugs） were 74.51% and 19.61% respectively. Intravenous drip was the main way of administration, 54 cases received antibiotics orally , none of them received intramuscular medication. The rate of changing two kinds of antibiotics ,three kinds of antibiotics and four kinds of antibiotics were 36.27%, 23.53% and 9.8% respectively. The rate of bacterial culture was 1.96%. The rate of duration of medication in less than three days,from three days to seven days and more than seven days were 24.50%, 48.04% and 21.57% respectively. The administration frequence was higher in cephalosporins, lincosamides, penecillins category than in other antibiotics. CONCLUSION： Rational use of anti-bacteria drugs was the main trend, however some problems still existed such as prophylactic administration of antibiotics, low delivery ratio of sample collection, irrational use of drugs, frequent change of antibiotics and drug abuse etc. Therefore, more efficient measures should be developed and implemented such as rational layout of wards, enhancing preoperative health care and rational administration of antibiotics etc.