我院围术期预防性使用抗菌药物的干预对照研究

Intervention-control study of preventative application of antibiotics in perioperative period in our hospital

目的调查本院围术期预防性应用抗菌药物情况,对比分析临床药师对合理使用抗菌药物的干预作用。方法收集临床药师未干预手术病例260例及药师参与干预后的手术病例260例,对比分析干预前后围术期预防性应用抗菌药物情况。结果干预后用药时机不合理的比例由干预前80.39%降低到6.92%,抗菌药物平均应用时间由干预前9.6 d减少到4.2 d;围术期抗菌药物预防性应用的合理性明显提高,伤口感染率无明显改变,但仍存在无指征使用抗菌药物、用药疗程偏长、剂量偏大等问题。结论外科围术期预防性使用抗菌药物可以降低并发症发生率,但在使用期间需要区分患者的病症情况,再进行用药,降低患者药物使用的剂量,避免药物使用过度,临床干预可以有效提高患者的用药合理性,但还需要进一步地加强干预管理。

Objective To investigate the preventative application of antibiotics in the perioperative period in our hos pital and compare and analyze the invention effect of clinical pharmacists on the rational antibiotics use.Methods 260 cases of surgical records before the intervention and 260 cases of surgical records after the intervention of the clinical pharmacists were collected.The preventative application situation of antibiotics in the perioperative period before and after the intervention was compared.Results After intervention,the incidence of unreasonable drug use reduced from 80.39% to 6.92% and the average application time of antibiotics reduced from 9.6 days to 4.2 days;the reasonability of the preventative application of antibiotics in the perioperative period improved significantly and the wound infection rate did not change obviously,but there were problems such as the application of antibiotics without indications,over long medication course and overlarge dosage.Conclusion The preventive application of antibiotics in the perioperative period can reduce the patients＇ incidence of complications,but the symptoms of patients should be distinguished be fore the drug use in order to reduce the drug dosage and possible overdose of patients.Clinical intervention can effec tively improve the patients＇ reasonability of drug use and the intervention management needs to be further strength ened.