Ⅰ类切口围手术期抗菌药物合理使用的干预对照研究

Case control study on the intervention with rational application of perioperative antimicrobial agents in typeⅠincision operations

目的探讨某院围手术期抗菌药物合理使用方案的可行性。方法对该院甲状腺、乳腺、腹外疝3种Ⅰ类切口患者围手术期抗菌药物使用的未干预前(2008年4—6月,非干预组,90例)和干预后(2010年4—6月,干预组,90例)情况进行对照研究。结果经干预后,上述Ⅰ类切口抗菌药物使用率和无指征预防用药率分别由干预前的100%、46.67%降至42.22%、8.89%;药物选择不合理率由干预前的66.67%降至1.11%;术前用药不合理率和术后用药不合理率分别由干预前的68.89%、68.89%降至7.78%、5.56%;平均抗菌药物费用由干预前的220.13元降至94.24元;上述指标两两比较,差异均有统计学意义(P<0.01)。结论该院所实施的干预措施对规范围手术期抗菌药物的合理使用起到了积极的作用,具有可行性和有效性。

Objective To evaluate the feasibility of rational application of perioperative antimicrobial agents in a hospital. Methods Application of perioperative antimicrobial agents in type I incision operations of thyroid gland, mammary gland and abdominal external hernia before intervention （April-June, 2008; 90 cases, nonintervention group） and after intervention （April June, 2010 ;90 cases, intervention group） were compared by case control study. Results Antimicrobial application rate and non-indicated antimicrobial preventive application rate decreased from 100% and 46. 67% in non-intervention group to 42.22% and 8. 89%o in intervention one respectively; The rate of irrational choice of drugs decreased from 66. 67% in nonintervention group to 1.11 % in intervention one; The pre- and post-operative irrational application rate of antimicrobial agents decreased from 68. 89% and 68. 89% in non-intervention group to 7. 78% and 5.56% in intervention one respectively; The average cost of antimicrobial agents decreased from 220. 13 yuan in nonintervention group to 94. 24 yuan in intervention one （P〈0. 01 ）. Conclusion The intervention for rational application of perioperative antimicrobial agents is feasible and effective.