2010年4月—2011年4月重庆市南川区人民医院泌尿外科抗菌药物临床应用分析

Analysis of Antibiotic Use in Patients in Department of Urinary Surgery of Chongqing Nanchuan District People's Hospital between April 2010 and April 2011

目的:评价重庆市南川区人民医院泌尿外科抗菌药物应用的合理性,提高该院临床使用抗菌药物的治疗水平,确保临床用药安全、有效、经济。方法:采用回顾性调查分析方法,随机抽查泌尿外科2010年4月—2011年4月出院的720份住院病历资料,进行统计分析。结果:共抽查720例住院患者,应用了抗菌药物者624例,抗菌药物的应用率高达86.67%(624/720),以单一用药和二联用药为主,药敏试验及病原送检率仅为4.81%(30/624)。抗菌药物单一使用率为60.28%(434/720),二联使用率为20.0%(144/720),三联使用率为6.39%(46/720)。抗菌药物使用频率排序居前3位的依次为头孢美唑、氟罗沙星、头孢西丁。另外,围术期预防性抗菌药物预防使用率为94.84%(551/581),其中85.54%(497/581)的手术患者预防用药时机不当。手术时间>3 h的患者术中未追加抗菌药物的有12例,术后抗菌药物平均应用时间为7.2 d。结论:泌尿外科抗菌药物的使用情况较以前有所好转,但仍存在药敏试验和病原标本送检率低、选药不当、给药剂量偏大、用药时间过长、围术期抗菌药物给药时机不合理等问题,需继续加强合理使用抗菌药物的宣传教育和监督管理,进一步规范使用抗菌药物。

OBJECTIVE： To evaluate the rationality in the use of antibiotics in patients in department of urinary surgery of Chongqing Nanchuan District People＇s Hospital in order to improve the level of antibiotic use and ensure safe,effective and economic use of antibiotics.METHODS： By a retrospective study,the medical records of 720 patients who discharged from the department of urinary surgery of our hospital between April 2010 and April 2011 were randomly sampled for statistical analysis.RESULTS： Of the total 720 cases reviewed,86.67%（624/720） received antibiotics,mostly in monotherapy or combination of two drugs.Of the 624 antibiotic receivers,only 4.81%（30/624） received drug susceptibility test and pathogen test.The rates of antibiotics used in monotherapy,combination therapy of two and combination therapy three drugs stood at 60.28%（434/720）,20.0%（144/720） and 6.39%（46/720）,respectively.The antibiotics topping the first three places in terms of use frequency were cefmetazole,fleroxacin and cefoxitin in order.In addition,the rate of perioperative use of prophylactic antibiotics stood at 94.84%（551/581）,with 85.54%（497/581） showing improper preventive medication timing.Among the patients in whom the operation duration was3 h,12 were not given added antibiotics.The postoperative antibiotic use duration stood at 7.2 days on average.CONCLUSION： There was improvement in antibiotic use in the patients undergoing urinary surgery as compared with before,but some unreasonable problems such as the low rates of susceptibility test and pathogen test,improper choice of drugs,large doses,prolonged drug use,and improper perioperative medication timing etc still existed.Therefore,efforts should be taken to strengthen publicizing and education as well as supervision and management on the rational use of antibiotics so as to further standardize the antibiotic use.