围手术期预防性使用抗菌药物分析

Prophylactic usage of antibiotics during perioperative period

目的了解某三甲医院外科围手术期患者抗菌药物的应用情况,评价其应用的合理性。方法采用回顾性分析的方法,对某三甲医院外科2010年4-6月住院患者120份病历资料进行了调查,探讨围手术期抗菌药物合理应用情况。结果外科围手术期患者的抗菌药物总的使用率96.7%,平均用药时间9 d,最长预防用药时间为20 d;其中用药>3 d者占74.2%;用药>7 d者占51.7%;抗菌药物使用占前8位的分别为奥硝唑、头孢替安、氨曲南、头孢唑林、头孢曲松、左氧氟沙星、头孢米诺、莫西沙星;其中单一、二联和三联用药分别为37.1%、48.3%、14.6%。结论某三甲医院不合理用药表现在选药不恰当,术后用药时间偏长,联合用药不合理,更换药品频繁,标本送检率低等,应加强监管,促进围手术期合理使用抗菌药物。

OBJECTIVE To investigate the situation of antibiotics utilization during perioperative period,evaluate the rationality of antibiotics usage in a certain hospital.METHODS The investigation of perioperative antibiotics utilization in 120 patients from Apr 2010 to Jul 2010 in the surgery was analyzed retrospectively in order to explore the rationality of antibiotics usage in perioperative period.RESULTS The total percent of antibiotics usage with surgical patients in perioperative period was 96.7%,and the average time of antibiotics utilization was 9 d,the longest time of it was 20 d.The application ratios of antibacterials use over 3 d was 74.2%,over 7 d was 51.7%.The top eight antibiotics applied were ornidazole,cefotiam,aztreonam,cefazolin,ceftriaxone,levofloxacin,cefminox,and moxifloxacin.There was 37.1% for one antibiotics usage,and 48.3% for two kinds of antibacterials,and 14.6% for three kinds antibiotics usage.CONCLUSION Unreasonable factors exists in the use of antibiotics in perioperative period,such as inappropriate antibacterials selection,the prolonged continuous drug use,irrational drug combination,frequent replacement in antibacterials,Specimen of low rate of examination,so the management of that should be strengthened,it is expected to enhance the rationality usage of the antibiotics.