药师干预腹股沟疝手术预防性应用抗菌药物的临床分析

Intervention of prophylactic use of antibiotics to herniorrhaphy by pharmacists

目的评价医院临床药师在干预手术预防用抗菌药物的成效,进一步改进临床药学工作。方法对医院临床药师干预后(2010年1-3月)腹股沟疝Ⅰ类手术预防用药的情况进行分析,分别从平均住院时间、给药时机、药品种类、给药疗程、联合用药以及药品费用等指标与临床药师干预前(2008年1-3月)的情况进行对比分析。结果入选腹股沟疝患者56例,经过临床药师的干预措施,总的药品费用下降3.17%,抗菌药物费用下降23.36%,抗菌药物用药天数平均每例患者减少2.51 d,抗菌药物选择趋于合理,主要是第二代头孢;平均联合用药率4.07%,显著低于2008年的47.0%,差异有统计学意义(P<0.01)。结论经过临床药师的干预以及医院对抗菌药物管理加强,医院在腹股沟疝手术的预防用抗菌药物在降低患者药品费用和抗菌药物应用的合理性上有明显的改善。

OBJECTIVE To evaluate on pharmacist-managed antimicrobial prophylaxis in medicare patients who underwent herinirrhaphy with an aim to better clarify indications and regimens for prophylaxis.METHODS Pharmacist management of antimicrobial prophylaxis was evaluated in medicare patients underwent clean heriniorrhaphy procedures from Peking University Shenzhen hospitals.RESULTS In hospitals with pharmacist-managed antimicrobial prophylaxis,drug charges were 3.17% lower（65.2 yuan less per patient,P=NS）,antibiotic medicine charge were 23.36% lower（259.38 yuan less per patient,P0.001）.the average day of antimicrobial prophylaxis reduced 2.51d per patient（P0.001）.The kinds of antimicrobials were more reasonable and 2nd Cephalosporins were the main choice.the average frequence of combine medicine were significant lower after pharmacist management（4.07%） than that before pharmacist management（47.0%）（P=0.002）.CONCLUSION The provision of pharmacist-managed antimicrobial prophylaxis is associated with significant improvement in clinical and economic outcomes for Medicare patients with a surgical code indicative of the need for antimicrobial prophylaxis.