我院心胸外科360例围术期抗菌药物使用分析

Analysis on 360 Cases of Perioperative Utilization of Antimicrobials in Cardiothoracic Department of Our Hospital

目的:促进我院心胸外科抗菌药物的合理应用。方法:按每月30份随机抽取我院2009年1月～12月心胸外科术后出院患者病历共计360份,对其抗菌药物临床应用情况进行统计、分析。结果:在360份病历中,术前预防使用抗菌药物352例,术后预防使用抗菌药物360例,术后使用率为100%。术前共使用5类8种抗菌药物,应用率最高为头孢硫咪138例,其次为头孢呋辛钠104例。二联用药共26例,无三联用药;病原学检查与药物敏感试验仅45例;预防用药时间最短1d,最长15d,平均5.65d;62例手术持续时间>3h,298例<3h,无术中追加抗菌药物病例。结论:我院心胸外科围术期抗菌药物应用品种选择基本合理,但存在不合理联合用药、用药时机不合理、用药时间过长、病原学检查不足等情况,亟待改善。

OBJECTIVE：To provide reference for the utilization of antimicrobials in cardiothoracic department of our hospital.METHODS：A total of 360 discharged medical records were collected from cardiothoracic department of our hospital from Jan.to Dec.in 2009 （30 medical records per month）.The utilization of antimicrobials was analyzed statistically.RESULTS：Of 360 medical records,352 cases received antimicrobials before operation while 360 cases received antimicrobials after operation.The utilization rate of antimicrobials after operation reached 100%.5 categories （8 kinds） of antimicrobials were adopted before operation.Cefathiamidine took up the first place in the list of utilization rate （138 cases）,followed by cefuroxime sodium （104 cases）.Two-drug were 26 cases while there was none of three-drug.Etiological examination and drug susceptibility test were only carried out for 45 cases.The minimum duration of preventive administration was 1 d and maximum duration 15 d with average duration of 5.65d.The duration of 62 operation cases were more than 3 hours while 298 cases less than 3 hours.None of cases received additional dose of antimicrobials.CONCLUSION：The selection of antimicrobials category is basically reasonable in cardiothoracic department of our hospital.But there are some problems in respects of irrational use of drug combination,unreasonable medication time,overlong medication duration,deficient etiological examination.Above problems should be resolved urgently.