内蒙古医科大学附属医院Ⅰ类切口手术预防性应用抗菌药物分析

Analysis of Utilization of Perioperative Use of Prophylactic Antibiotics in Patients Undergoing Type Ⅰ Incision Surgery in Inner Mongolia Medical University Affiliated Hospital

目的:了解我院Ⅰ类切口手术预防性应用抗菌药物情况,为临床合理用药提供参考。方法:利用新型临床药学管理系统(CPMS)筛查及统计2010—2011年7月我院99 329例住院患者资料及用药情况。结果:Ⅰ类切口手术患者有22 842例,其中预防性应用抗菌药物的患者20 603例;术前30 min～2 h给药的有5 894例(占28.61%);联合用药的有2 505例(占12.16%);预防性用药以第3代头孢菌素为主,第2代头孢菌素次之。结论:利用CPMS可以进行海量数据的大样本分析,2010—2011年6月我院Ⅰ类切口手术预防性应用抗菌药物存在用药指征不明确、预防性应用抗菌药物选择起点过高、给药时间不正确、联合用药不合理等情况。进入2011年7月,随着全国抗菌药物临床应用专项整治活动以来,抗菌药物不合理使用情况有所改观。

OBJECTIVE：To investigate the use of prophylactic antibiotics in patients undergoing typeⅠincision surgery in our hospital for clinical reference of rational antibiotic use.METHODS：The medical records of 99 329 patients hospitalized in our hospital in July from 2010 to 2011 were analyzed statistically with respected to the antibiotic use using new clinical pharmacy management system.RESULTS： Of the total 22 842 cases,20 603 used antibiotics;5 894 cases（28.6%） received antibiotics 30 min-2 hours before operation;drug combination was noted in 2 505 cases（12.16%）.The third generation cephalosporins was used most frequently prophylactically followed by second generation cephalosporins.CONCLUSION：The new clinical pharmacy management system makes large sample analysis of massive data possible.The prophylactic use antibiotics in patients undergoing typeⅠincision surgery in June from 2010 to 2011 was irrational due to undefined medication indication,high starting point in the selection of prophylactic antibiotics,incorrect time of administration and irrational drug combination;however,in July 2011,the irrational use of prophylactic antibiotics showed improvement owing to the practice of national special rectification activity on clinical use of antibiotics initiated by Ministry of Health.