某“三甲”医院3种清洁手术围术期预防性应用抗菌药物调查分析

Prophylactic Use of Antibiotics During Perioperative Period in Patients Undergoing Three Types of Aseptic Operations in a 3A Grade Hospital

目的:评价某"三甲"医院甲状腺手术、乳腺手术、疝气修补术(简称"3种清洁手术")预防性应用抗菌药物情况。方法:回顾性调查某"三甲"医院2008年3月104例3种清洁手术患者预防性应用抗菌药物情况。结果:104例患者中,抗菌药物预防性应用率达100%;术前应用≤2h者60例(占57.69%),>2h者31例(占29.81%);术后应用≤24h者43例(占41.35%),24<t≤48h者14例(占13.46%),其中累计应用抗菌药物时间最长者达17d。预防性应用抗菌药物涉及9类,种类最多的为头孢菌素类,其余依次为青霉素类、复合β-内酰胺酶抑制剂、硝基咪唑类、氟喹诺酮类和氨基糖苷类;涉及药品25种,使用频次列前3位的分别为头孢硫脒、青霉素钠、呋布西林钠。平均住院药品费用2433.05元、住院抗菌药物总费用占总药品费用的40.61%。结论:该院3种清洁手术预防性应用抗菌药物存在不合理现象,应引起重视。

OBJECTIVE： To evaluate the prophylactic use of antibiotics during perioperative period in patients undergoing thyroid surgery, breast surgery or herniorrhaphy. METHODS： The case records of 104 patients undergoing thyroid surgery, breast surgery or herniorrhaphy in Mar. 2008 were reviewed retrospectively regarding the prophylactic use of antibiotics. RESULTS： All of the 104 patients （100%） received antibiotics, of whom, 60 （57.69%） received antibiotics at 42 h and 31 （29.81%） at ） 2 h before operation; 43 （41.35%） received antibiotics at 424 h and 14 （13.46%） at 24〈t≤48 h after operation. The longest duration of taking antibiotics was 17days. 9 categories of antibiotics were used in the 104 patients, dominating the first place were cephalosporins, followed by penicillins, composite β lactamase inhibitors, nitromidazoles, quinolones and aminoglycosides. A total of 25 kinds of drugs were involved, leading the first three places on the list of DDDs were cefathiamidine, penicillin sodium and furbenicillin sodium. The patients＇ total drug cost was 2 433.05 Yuan on average, with the cost of the antibiotics accounting for 40.61%. CONCLUSION： Great attention should be paid to the serious problem of irrational use of prophylactic antibiotics in the perioperative period in a 3A grade hospital.