某院Ⅰ类手术切口围术期抗菌药物应用分析

Analysis of use of antibiotics in 538 cases of type Ⅰ incision operation in this hospital

目的了解某院Ⅰ类手术切口围术期使用抗菌药物特点及合理性情况,为临床正确规范使用抗菌药物提供参考依据。方法随机抽取2011-11至2012-04共538例Ⅰ类手术切口病例,统计分析手术类型、抗菌药使用率、使用品种、联合用药、用药时机、用药时长等情况。结果Ⅰ类手术切口抗菌药使用率为84.01%,以头孢硫脒与头孢噻肟使用比例最高,占所有使用病例的20.58%和17.26%,联用抗菌药比例为6.42%。首次给药时间为术前2～24 h、0.5～2.0 h和术后的比例分别为8.62%、46.24%和45.13%。给药时间控制在术后24 h内者为18例,25～48 h内者为81例,大于48 h者为353例,平均使用6.83 d。结论此院Ⅰ类手术切口预防使用抗菌药物存在指征把握不严、抗菌药选择不合理、给药时机与用药时长不当等问题,应进一步加强行政监管与临床药师参与力度。

Objective To know the characteristics and reasonable use of antibiotics in type Ⅰ incision perioperativperiod in this hospital, and provide a reference for rational use to prevent infection in clinicl. Methods 538 cases of typeⅠ incision operation were sampled randomly from November 2011 to April 2012. The type of surgery, the utilization of antibiotics, the use of varieties, combina- tion therapy, medication timing and duration were investigated and analyzed. Results The utilization rate of drugs in type Ⅰ incision operation was 84. 01%. The eefathiamidine and cefotaxime held the higher proportion of drugs, accounting for 20. 58% and 17. 260/0. The combination rate of antibiotics was 6.42%. The proportion of the first administration time in preoperative 2 - 24 h, 0. 5 - 2 h and postoperatively were 8.62%, 46. 24% and 45.13%, respectively 18 cases had the medication with in 24 h after surgery, 81 patients with in 25 - 48 h, and other 353 cases beyond 48 h. The average number of days for antibiotics use was 6. 83 days. Conclusions The use of antibiotics for preventing infection has several problems in this hospital ： indications are not strict, choice of varieties is unreason- able and the timing of administration and duration of treatment are incorrect, which need strengthen the administrative supervision and the level of participation of clinical pharmacists.