95例起搏器植入患者预防性应用抗菌药物分析

Analysis of Preventive Antibacterials Use in 95 Pacemaker-Embedded Patients

目的分析起搏器植入患者预防性应用抗菌药物的情况及存在的问题。方法对某三级甲等综合性医院2006年1月至2007年12月的95例起搏器植入患者预防性应用抗菌药物的情况进行调查分析。结果95例起搏器植入患者抗菌药物使用率为100%,按用药频次高低排序的前3类药物是喹诺酮类、第3代头孢菌素类、克林霉素类,95例患者中无使用第1代头孢菌素类者。用药时间为术前(切皮前)大于2h者82例(86.32%),术前0.5～2h内使用者13例(13.68%),无术后才开始用药者。用药疗程最短5d,最长12d,平均9d。5个抗菌药物费用档级中使用低档(2000元以下档)抗菌药物者占大多数。结论该院起搏器植入患者抗菌药物选择很不规范,存在用药档次过高、疗程过长、用药时机欠佳、联合用药不合理、药费比重过大等问题,应加强对医院抗菌药物使用的宣传和管理。

Objective To analyse the current using status and the existing problems of preventive antibacterials use for the pacemaker （PM） -embedded patients. Methods To investigate and analyse the antibacterials use in 95 PM- embedded patients from January 2006 to December 2007. Results Antibacterials were used in all of these patients. Drug choosing： the most frequently used antibacterials were quinolones, cephalon Ⅲ and cephalon Ⅱ. However, cephalonⅠ was used in none of these patients. The beginning time of drug use： 82 （86.32%）cases were administrated more than 2 h before operation, 13（13.68% ） administrated 0.5-2 h, and none were used after operation. The course of the administration： the shortest was 5 d, the longest 12 d and the average 9 d. Antibaterials costs： the costs of 61.05% patients was less than 2 000 yuan, 29. 47% was 2 000-4 000 yuan, 9.47% more than 4 000 yuan. Conclusion The choose of antibacterials was out of standard, the course of drug using was too long, the time to use antibaterials and the combination medication were unreasonable, the proportion of the drug costs was too high. So the publicity and the regulation should be strengthened in our hospital.