115例老年患者Ⅰ类手术切口预防应用抗菌药物分析

Prophylactic use of antibiotics in 115 elderly patients with type Ⅰ surgical incision

目的调查分析和评价医院>60岁老年患者Ⅰ类切口手术围手术期抗菌药物使用情况。方法抽取医院2010年1-12月专项手术切口监测资料中老年患者Ⅰ类切口手术115例,对其围手术期预防应用抗菌药物情况进行整理分析。结果 115例老年手术患者均预防性使用抗菌药物,使用率为100.00%,使用频率前3位为头孢西丁、头孢米诺、克林霉素;术前<2h或麻醉开始时使用抗菌药物104例,占90.43%,术前未用术后用11例,占9.6%;用药疗程为3～13d,平均6.7d。结论加强抗菌药物的应用监管,正确把握给药时机;术中,提高手术技能,缩短手术时间、术后用药时间;严格按照《抗菌药物临床应用指导原则》使用药物,加强临床医师与药师之间的合作,减少不合理用药,促进抗菌药物在老年患者围手术期使用的安全、有效、经济。

OBJECTIVE To investigate and evaluate the use of antibiotics in patients aged over 60 years old who underwent type Ⅰ incision surgery during perioperative period.METHODS A total of 115 patients undergoing type Ⅰ incision surgery from Jan.to Dec.2010 were selected.The condition of prophylactic use of antibiotics during perioperative period was analyzed.RESULTS All of the 115 patients received prophylactic antibacterials with the utilization rate of 100.0%.The top 3 most commonly used antimicrobial agents were cefoxitin,cefminox,and clindamycin.104（90.4%） patients used antibiotics within 2h before operation,and 11（9.6%） patients did not receive antibiotics until the operation was completed;the course of medication was 3-13d with the mean duration of 6.7 d.CONCLUSION To strengthen the regulation for use of antimicrobial drug and correctly grasp the dosing time,improve the surgical skills,shorten surgical duration and postoperative medication duration;use antibiotics by strictly referring to Guidelines for clinical use of antibiotics;enhance the collaboration between the clinician and the pharmacist,reduce the unreasonable use of antibiotics are essential ways to promote the safe,effective,and economical use of antibiotics during perioperative period.