南充地区Ⅰ类切口预防用抗菌药物的调查分析

Application of antibiotics during perioperative period of class I incision surgery in Nanchong

目的调查南充地区医院Ⅰ类切口围术期预防用抗菌药物情况。方法选取南充地区10家基层医院289份Ⅰ类切口出院病历,根据抗菌药物合理应用评价标准,对其适应证、药物选择、用药时间、溶媒选择、用法用量、联合用药等情况进行统计分析。结果289份Ⅰ类切口病历中158例使用抗菌药物,使用率为54.7%;其中切皮前30 min^2 h内给药135例,占85.4%;预防性应用抗菌药物共涉及7类17种,应用频次排序列前3位的依次为头孢硫眯(42例,26.3%)、头孢西丁(21例,13.1%)、克林霉素(20例,12.5%);单一用药156例(98.7%),二联联合用药2例(1.3%);43.0%的患者预防用抗菌药物疗程超过24 h。结论南充地区Ⅰ类切口围手术期预防应用抗菌药物存在不合理现象,需进一步规范临床医师抗菌药物使用行为,制订完善的围手术期预防用药管理措施。

Objective To investigate the prophylactic use of antibiotics for class I incision surgery in hospitals in Nanchong. Methods A total of 289 patients who received class I incision surgery in 10 hospitals of Nanchong were retrospectively analyzed. According to evaluation standards for rational use of antibiotics, the indication, selection of antibiotics, timing of drug use, proper selection of solvent, usage and dosage, and drug combination were analyzed statistically. Results Among 289 patients, 158 patients underwent clean surgery were treated with antibacterials （54.7%）. 135 patients （85.4%） were received antibiotics in 30 min-2 h before the operation. 7 categories and 17 kinds of antibiotics were used in the type I incision operation. The first 3 drugs in the list of frequently use were cefathiamidine （42 cases）, cefoxitin （21 cases） and clindamycin （20 cases）. 156 cases received single kind of antibiotics （98.7%） and 2 cases combination of antibiotics （1.3%）. 43.0% of patients＇ perioperative period antibiotic prophylaxis course were over 24 h. Conclusion There exists irrational phenomenon in the preoperative application of antibiotics for class I incision surgery. It is necessary to further standardize the clinical application of antibiotics and develop complete measures for prophylactic use of antibiotics.