临床药师对围手术期预防性应用抗菌药物的干预作用

CONTRASTIVE ANALYSIS ON THE PROPHYLACTIC USE OF ANTIBACTERIALS IN PERIOPERATIVE PERIOD OF CLINICAL PHARMACIST INTERVENING SURGICAL OPERATIONS

目的了解我院外科围手术期预防性应用抗菌药物的使用情况,对比分析临床药师对合理使用抗菌药物的干预作用。方法收集临床药师参与查房前2007年外科手术病历120例及参与查房1年后2010年的手术病历120例,对比分析干预前后围手术期预防性应用抗菌药物的使用情况。结果干预后用药时机不合理由74.2%减少到4.2%,Ⅰ类切口抗菌药物平均应用时间由4.0 d减少到1.9 d;Ⅱ类切口抗菌药物平均使用时间由5.5 d减少到3.6 d,围手术期抗菌药物预防性应用的合理性明显提高,伤口感染率无明显改变,但仍存在无指征使用抗菌药物,用药疗程偏长,剂量偏大等问题。结论我院外科围术期预防性应用抗菌药物渐趋合理,但仍需进一步提高合理用药水平,临床药师的监督作用仍需加强。

Objective To discuss the preventive use of antibacterials in perioperative period of clinical pharmacist intervening surgical departments of our hospital,and to analyze the intervening effect of clinical pharmacists on rational use of antibacterials comparatively.Methods Both 120 cases in 2007 before clinical pharmacist intervening and 120 cases in 2010 after intervening were collected from surgical operations in our hospital,and the comparative analysis was made in the time pre-and post-intervening of using antibacterials in perioperative period.Results The average time of application of antibacterials in typeⅠ incisions reduce from 4.0 d to 1.9 d;meanwhile,from 5.5 d to 3.6 d in type Ⅱ incisions;the rational preventive use of antibacterials in perioperative period was markedly improved.Operations infection rate did not change significantly.However,there were still many problems,such as no indication of using antibacterials,rather long drug treatment and relatively large doses,etc.Conclusion The prophylactic antibacterials use in the surgical perioperation period tend to be rational in our hospital,but the rational drug using level should be further improved,the oversight role of clinical pharmacists still need to be strengthened.