摘要
目的:探讨河池市东兰县人民医院临床药师对普外科Ⅰ类切口手术预防性应用抗菌药物的干预作用及效果.方法:收集2010年5月-2011年4月(干预前)普外科出院病例205例,设为非干预组;干预分为2个阶段,2011年5月-2012年4月为干预的第1阶段,收集此阶段普外科出院病例251例;2012年5月-2013年4月为干预的第2阶段,收集此阶段普外科出院病例263例,对干预前后普外科Ⅰ类切口手术预防性应用抗菌药物的合理性进行比较.结果:第一阶段干预后,抗菌药物使用率由干预前的100%下降为99.6%,疗程由干预前的5~14 d(平均8.39 d,且出院还带口服抗菌药物)下降为1~8d(平均2.8d),未用抗菌药物者已有1例,疗程≤24 h、25 ~48 h的比例从零到明显提升,疗程≤24 h的比例已达40.64%,疗程为3~7d、>7d的比例明显下降,用药选择、给药时间、术中用药、用法与用量逐步合理,联合用药、给药途径全部合理;第二阶段干预后,抗菌药物使用率由干预前的100%下降为5.70%,且后阶段有用药指征的患者也不预防性用药,疗程为0~1d(平均0.057 d),其余各项也全部合理且切口甲级愈合、无感染.结论:临床药师对普外科Ⅰ类切口手术预防性应用抗菌药物的干预效果显著,全部达到2012年全国“抗菌药物临床应用专项整治活动”方案的要求.
OBJECTIVE:To evaluate the role and effectiveness of clinical pharmacists' intervention on the prophylactic use of antibiotics in surgical patients undergoing type Ⅰ incision surgery in Hechi Donglan County People's Hospital.METHODS:205 discharged surgical cases from May 2010 to April 2011 (before intervention) were assigned to non-intervention group and 251 discharged surgical cases collected during stage Ⅰ (from May 2011 to April 2012) vs.263 discharged surgical cases collected during stage Ⅱ (from May 2012 to April 2013) were assigned to intervention group.The rationality in the prophylactic use of antibiotics in surgical patients undergoing type Ⅰ incision surgery before and after intervention was compared.RESULTS:After stage Ⅰ intervention,the proportion of patients administered with antibiotics reduced from 100% (before intervention) to 99.6% (after intervention) and the course of treatment was reduced from 5-14 days before intervention (an average of 8.39 days,with discharge medication of oral antibiotics) to 1-8 days (an average of 2.8 days); antibiotics were not used in 1 case; the proportion of patients administered with antibiotics for ≤24 hours for 25-48 hours showed sharp increase from 0% ; the proportion of patients administered with antibiotics for ≤24 hours has reached 40.64% ; the proportion of patients administered with antibiotics for 3-7 days or > 7 days showed a sharp decrease ; the drug choice,administration time,intraoperaitve medication,dosage & administration became more and more rational,and drug combination and routes of administration were completely rational.After stage Ⅱ intervention,the proportion of patients administered with antibiotics reduced from 100% (before intervention) to 5.70% (after intervention) and even the patients with medication indications had no prophylactic use of antibiotics in the later stage ; the course of treatment was 0-1 day (an average of 0.057 days),and all the other antibiotic use indicators were rational with grade A healing of incision (without infection).CONCLUSION:Clinical pharmacists' intervention on the prophylactic use of antibiotics in surgical patients undergoing type Ⅰ incision surgery achieved noticeable effectiveness and met the requirement of "special rectification activities in 2012 on clinical application of antibacterial drugs'.
出处
《中国医院用药评价与分析》
2014年第2期168-171,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
关键词
临床药师
干预
普外科Ⅰ类切口手术
抗菌药物
预防性用药
Clinical pharmacists
Intervention
Type Ⅰ incision surgery
Antibiotics
Prophylactic use of drug