上海市嘉定区中医医院围手术期病人抗菌药物的应用分析

Utilization of antibacterials during perioperative period in the Traditional Chinese Medicine Hospital of Jiading District of Shanghai

目的:调查和评价上海市嘉定区中医医院的清洁手术和清洁-污染手术围手术期抗菌药物的使用情况,以提高合理用药水平。方法:抽取本院2011年1-6月共200例清洁手术和清洁-污染手术病例,对抗菌药物预防用药情况进行统计和分析。结果:所有手术病人均使用了抗菌药物,头孢菌素的费用居首位。清洁手术所用抗菌药物有6大类14个品种,其中头孢菌素的费用占74.3%;清洁-污染手术所用抗菌药物有6大类13个品种,其中头孢菌素的费用占55.6%。清洁手术和清洁-污染手术中抗菌药的使用强度分别为46DDD和44DDD。结论:本院围手术期预防使用抗菌药存在无指征用药、用药起点过高、联合用药比例高和预防用药时间过长等问题,应进一步加强抗菌药物的管理。

Objective：To investigate and evaluate the prophylactic use of antibacterials during perioperative period of clean and clean-contaminated surgeries in Traditional Chinese Medicine Hospital of Jiading District of Shanghai,in order to elevate the level of rational use of drugs. Methods：Two hundred eases of clean and clean-contaminated surgeries were selected from the hos- pital from January to June in 2011 ,and prophylactic use of antibacterials were statistically analyzed. Results： Antibacterials were used in all the surgical patients, with the cost of cephalosporins ranked the first. Six categories of drugs including 14 kinds of antibaeterials were used in clean surgeries, of which the cost of cephalosporins accounted for 74. 3%, while six categories of drugs including 13 kinds of antibacterials were used in clean-contaminated surgeries,of which the cost of cephalosporins accoun- ted for 55. 6%. Antibacterial use intensity in clean and clean-contaminated surgeries were 46DDD and 44DDD, respectively. Conclusion： There exist some probl.ems in the prophylactic use of antibacterials during perioperative period, e. g. the application of anti bacterials without indications, excessively high dosage at the beginning,high rate of combined use of drugs and prolonged use of prophy- lactic drugs. Management of antibacterials should be further heightened.