423例Ⅰ类切口手术预防性应用抗菌药物分析

Use of Prophylactic Antibiotics in Patients Undergoing Type Ⅰ Incision Operations:Analysis of 423 Cases

目的:调查我院Ⅰ类切口手术围术期预防性应用抗菌药物情况,以提高我院抗菌药物的合理应用水平。方法:采用回顾性方法,随机抽取我院2011年1—12月423份Ⅰ类切口手术患者的出院病历,对预防性应用抗菌药物的合理性进行分析。结果:抗菌药物预防应用率达59.8%(253/423),无指征预防用药为4.7%(12/253);主要使用的抗菌药物是头孢西丁钠和头孢呋辛钠;人均预防用药天数为2.98 d,人均药品金额为414.97元;药物选择的合理率为32.4%(82/253),用法与用量合理率为88.1%(223/253),给药时间合理率为39.5%(100/253),溶剂体积的合理率为87.4%(221/253),用药疗程的合理率为64.0%(162/253)。结论:我院Ⅰ类切口手术预防性应用抗菌药物还存在不合理使用现象,应该制定规范的围术期预防性应用抗菌药物干预措施,以提高医院合理用药水平。

OBJECTIVE： To investigate the perioperative undergoing type I incision operations in our hospital in order METHODS： In this retrospective review, the medical records of operations （thyroid, breast and herniorrhaphy） and discharged period of 2011 for analysis of the perioperative utilization utilization of prophylactic antibiotics in patients to improve the rationality of the antibiotic use. 423 patients who had undergone type I incision from hospital were randomly selected during Jan. -Dec. of prophylactic antibiotics. RESULTS： The rate of prophylactic use of antimicrobials was 59.8% （253/423） ; the rate of non-indicative medication was 4.7% （ 12/ 253 ）. The predominantly used antimicrobials were cefoxitin sodium and cefuroxime sodium. The mean duration for perioperative use of prophylactic antibiotics were 2.98 days and the per capita antibiotic cost was 414. 97 yuan. The rate of reasonable choice of antibacterials was 32. 4% （82/253）, with 88.1% （223/253） rational in dosage and administration, 39.5% （100/253） rational in administration time, 87.4% （221/253） rational in volume of solvents and 64. 0% （162/253） rational in medication duration. CONCLUSION： Irrational phenomena were noted in prophylactic antibiotic use for patients undergoing type I operations in our hospital. Intervention measures aimed at standard perioperative antibiotic use should be taken to improve hospital rational drug use level.