临床围术期预防性应用抗菌药物的合理性探讨

Rationality of Perioperative Use of Prophylactic Antimicrobials

目的:分析眉山市人民医院围术期抗菌药物的使用情况,促进抗菌药物的合理应用。方法:抽取2009年1月—2010年5月手术患者出院病历611例,进行回顾性调查,结合收集的实验室药敏试验数据信息,根据调查数据统计归纳;以《抗菌药物临床应用指导原则》为依据,对我院围术期抗菌药物的使用进行合理性评价。结果:611例手术中,606例使用了抗菌药物,抗菌药物使用率为99.18%。合理使用抗菌药物13例,占2.13%;不合理使用598例,占97.87%。抗菌药物的总金额为234 137.82元,由于不合理用药,造成多花费205 426.11元,占抗菌药物总金额的87.74%。结论:外科围术期抗菌药物合理应用与卫生部《抗菌药物临床应用指导原则》的要求有较大差距,临床医师应加强学习、提高素质,药事管理委员会应加大监管力度,药学部门应进一步加强抗菌药物合理应用的指导和管理,提高抗菌药物合理应用水平。

OBJECTIVE：To analyze the perioperative antibiotic use so as to promote rational use of antibiotics in Meishan Municipal People＇s Hospital.METHODS： A total of 611 medical records of surgical patients who had been discharged from our hospital from Jan.2009 to May 2010 were retrospectively investigated with susceptibility test data collected and analyzed statistically.The rationality of the perioperative antibiotic use was evaluated in accordance with the ＂Guiding principle for clinical application of antibacterials＂.RESULTS： Of the 611 surgical cases,606（99.18%） used antibiotics;13（2.13%） used antibiotics rationally and 598（97.87%） irrationally.The total consumption sum of antibiotics stood at 234 137.82 Yuan,and the irrational drug use caused an extra cost of 205 426.11 Yuan which accounted for 87.74% of total antibiotic costs.CONCLUSION： There is a long way to go before the rationality of perioperitve antibiotic use meeting the ＂Guiding principle for clinical application of antibacterials＂.It is important for clinicians to strengthen learning and improve their quality,for pharmaceutical management committee to strengthen supervision and for pharmacy departments to further strengthen guidance and management for the rational use of antibacterial drugs in order to improve the rational level of antibiotic use.