外科围手术期预防应用抗菌药物调查分析

Antibiotic prophylaxis during perioperative period of surgery

目的了解外科围手术期预防应用抗菌药物的现状,分析评价其使用的合理性,为临床合理使用抗菌药物提供参考依据。方法抽查2010年8月部分外科出院手术病历419份,对数据进行统计分析。结果 419例手术患者均使用抗菌药物,使用率为100.00%,使用最频繁的为头孢菌素类;术前用药>2h者79例占18.85%,术前用药≤2h者151例占36.04%,术前未用术后用药者189例占45.11%;术后持续用药≤24h者8例占1.91%,25～72h者75例,占17.90%,>72h者336例,占80.19%;两联用药占24.82%,多联用药占15.04%。结论围手术期预防用抗菌药物存在一定的误区,品种选择起点高、用药时机不当、术后用药持续时间过长、联合用药指征不明确,应加强对临床医师使用抗菌药物的规范教育,使抗菌药物的使用逐步趋于规范,减少细菌耐药性的发生。

OBJECTIVE To understand the current status of antibiotic prophylaxis during the perioperative period of surgery and analyze its rationality so as to provide basis for clinical reasonable use of antibiotics： METHODS A total of 419 patient who discharged from the hospital in Aug 2010 were randomly selected, the statistics were taken for statistical analysis. RESULTS All the 419 patients used antibiotics with the utilization rate of 100.0%, cephalosporins were the most frequently used. There were 79 （18.85 %） patients who used antibiotics more than 2 hours before the surgery, 151 （36.04%） patients who used antibiotics less than 2 hours before the surgery, 189 （45.11%） patients who used after the surgery and did not use before the surgery. There were 8 （1.91%） patients who used antibiotics continuously for less than 24 hours after the surgery, 75 （17. 90%） patients who used antibiotics between 25-72 hours, and 336 （80.19%） patients who used antibiotics for more than 72 hours. The patients who used two-therapy accounted for 24. 82%, and the patients who used multiple drugs accounted for 15.04%. CONCLUSION There are some errors in the antibiotics prophylaxis during the perioperative period, including the high starting point of drug selection, inappropriate medication timing, and unclear indications for combination use. It is necessary to strengthen the standard use of antibiotics so as to reduce the incidence of bacterial drug resistance.