Ⅰ、Ⅱ类切口围手术期抗菌药物临床合理应用分析

Research of rational use of antibiotics at perioperative period of type Ⅰand Ⅱ incision operations

目的:通过对我院外科围手术期抗菌药预防性应用的干预性研究,为临床抗菌药的应用和管理提供依据。方法:抽取我院2009年3月298份出院病历(干预前)及2009年9月284份出院病历(干预后),进行干预前后围手术期预防性应用抗菌药物合理性对照研究。结果:经临床药师干预,围手术期预防用药在适应证、药物选择、用法用量、超权限应用抗菌药物、溶媒选择、给药途径、联合用药、给药时机、不良反应的发生和禁忌证方面均明显提高(P<0.05);住院药品总费用占总住院费用的比例由46.38%降至34.89%;人均预防用时间和人均住院天数分别下降了2.15d和3.87d。结论:在医院内制定规范的围手术期预防用抗菌药物干预措施,使之具有可行性和有效性,并为临床药师走向临床指导临床合理用药,提供一套行之有效的工作模式。

OBJECTIVE To investigate our hospital perioperative prophylactic use of antibiotics in the intervention studies, providing basis for clinical application and management of antibiotics and management basis. METHODS A total of 298 discharged medical records were collected from Mar. in 2009 as control group and analyzed retrospectively. A total of 284 discharged medical records were interventionally treated with perioperative prophylactic use of antibiotics. RESULTS After interventional measures by clinical pharmacists, the total cost of hospital drugs the and its proportion of in total hospital costs was decreased from 46. 38% to 34. 89%; total hospitalized days and days of antibiotic use decreased by 2. 15 days and 3. 87 days （P〈0. 01）. CONCLUSION The intervention measures were effective and feasible. This principle can contribute to improving the rational use of antibiotics, and decreasing the application of antibiotics. It can also provide a feasible and effective model for designing clinical pathway to reduce the cost of drugs.