围手术期抗菌药物应用管理方法探讨

Administration method of antibiotics application during perioperative period

目的探讨外科围手术期预防应用抗菌药物的管理重点,了解医院围手术期患者抗菌药物使用现状和存在的问题,确定抗菌药物应用管理重点。方法利用北京市医院感染监控系统,设计合理预防应用抗菌药物评价表,对2008、2009年完善管理措施后的住院患者抗菌药物应用调查资料进行分析,分析预防应用抗菌药物情况。结果手术科室围手术期抗菌药物使用率95.53%,抗菌药物≤72 h使用率63.23%,Ⅰ类切口手术抗菌药物单次使用率5.22%。结论严格控制Ⅰ类切口手术用药,加强对围术期预防用药时间限制,采取有效措施限制高级抗菌药物使用,以减少细菌耐药。

OBJECTIVE To explore the emphasis of antibiotics administration in preventing surgical infection during perioperative period,and to investigate the situation and problem of antibiotics usage in the patients of perioperative period in hospital and define the administration emphasis of antibiotics.METHODS The evaluation form of rational use of antibiotics was designed by using the hospital infection control system in Beijing.And the form was used to analyze the clinical use of antibiotics in preoperative patients who were investigated after taking management measures in 2008 and 2009.RESULTS The total rate of use antibiotics during perioperative period in surgery was 95.53%,and the use rate in 72 hours was 63.23%,and the use rate of the antibiotics for one time was 5.22% in type I incisions.CONCLUSION The management emphasis of antibiotics during perioperative period in surgery departments should befacus on strongly control the use of antibiotics in type Ⅰ incisions to reduce the use rate effectively,to limit the prevention use time of antibiotics in 72 hours and the use of high-grade antibiotics to reduce the resistant rate of bacterias.Necessary comprehensive executive intervention is the assurance of rational use of antibiotics.