某院外科围手术期抗菌药物预防性应用分析

Analysis of Perioperative Use of Prophylactic Antibiotics

目的:评价某院外科围手术期抗菌药物的应用现状。方法:随机抽取2006年4～8月某院外科手术病例210例,依据《抗菌药物临床应用指导原则》,调查围手术期抗菌药物的预防性应用情况。结果:该院外科围手术期抗菌药物应用率达98·10%,清洁手术抗菌药物应用率为96·97%,其他类手术抗菌药物应用率达100%;术前0·5～2h应用抗菌药物占25·73%,术后应用抗菌药物占21·84%,术中应用抗菌药物占52·43%;抗菌药物平均应用时间为3·17d,最长达13d。清洁手术、清洁-污染手术、污染手术术后应用抗菌药物的时间分别为1·40、3·60、8·19d;单独应用抗菌药物有23种,列前5位的分别为头孢呋辛、拉氧头孢、阿莫西林/克拉维酸钾、头孢米诺、去甲万古霉素。结论:该院抗菌药物应用率偏高,各类手术预防用药指征不明确,用药目的和针对性不强,亟待实施规范化管理。

OBJECTIVE： To study the perioperative use of prophylactic antibiotics in a hospital. METHODS： 210 surgery patients were sampled randomly from Apr. to Aug.2006 in a hospital and investigated in respect of the perioperative use of prophylactic antibiotics based on the Guiding Principle of the Clinical Application of Antibacterials .RESULTS： Of the 210 cases, the ratio of perioperative use of antibiotics were as high as 98.10%, the application ratio of antibiotics in depuratory operation was 96.97%, and were 100% in other kinds of surgeries.The application ratios of antibacterials 0.5-2 h before surgery, after operation and during operation stood at 25.73 %, 21.84% and 52.43%, respectively.The average duration of antibiotic use was 3.17 d, with a maximum of 13 d .The duration of antibiotic use in depuratory operation, depuratory- eontaminant operation and contaminant operation were 1.40,3.60 and 8.19 d, respectively. Antibacterials used singly totaled 23 kinds, of which, cefuroxime, latamoxef, amoxicillin/potassium clavulanate, cefminox and norvancomycin hydrochloride topped the first 5 places.CONCLUSION：The results show that the rate of application rate of antibiotics in this hospital is on the high side, the preventive medication indications were unclear and the drug use was lack of special aim, the management on which remains to be standardized.