246例胆道围手术期的抗菌药物预防应用调查

Surveying in 246 cases of defending use of antibacterials during perioperation for biliary tract

目的 :了解胆道围手术期抗菌药物使用情况 ,指导临床合理用药。方法 :回顾性调查 2 0 0 0年 1月至 6月胆道外科手术病历 2 4 6份 ,根据抗菌药物使用管理有关规定 ,针对胆道感染和手术常见致病菌 ,结合抗菌药物抗菌谱及作用特点 ,探讨临床预防用药的合理性。结果 :抗菌药物使用率最高前 3位分别是替硝唑、甲硝唑、替卡西林 /克拉维酸钾。疗程平均为 3 3d。术前用药组、术后用药组及术前与术后用药组分别是 0例 ,2 2 3例及 2 3例。单用抗菌药物 5 7例 ,联合用药包括 2种以上 189例。对于择期手术 ,无论开腹手术还是腹腔镜手术 ,单用与联用抗菌药物伤口感染率无显著性差异。结论 :抗菌药物的预防用药指征基本符合要求 ,但在用药时机、药物品种、用药疗程及联合用药等方面的合理性有待改善。预防性应用抗菌药物 。

AIM: To realize the circumstances of antibacterials used in perioperation for biliary tract, and to get a guidance for rational drug use. METHODS: We retrospected 246 cases of biliary surgery from January to June in 2000. Following the rules of antibacterial agent use, aiming at the common bacteria in biliary surgery and combined with the antibacterial spectrum of drug, we probed to the rationality of clinic defending use of antibacterials. RESULTS: Three of the antibacterials were used most frequently, they were: timidazole, metronidazde, ticarcillin sodium/potassium clavulanate. The average period of treatment was 3 3 d. The number in the groups of preoperative use, postoperative use and the group of both preoperative and postoperative, were 0, 223 and 23 cases respectively. Fifty seven cases used single sort. One hundred and eighty nine cases used more than 1 sort of antibacterial agent. There was no special difference for incision infection between single use and combined use cases in laparoscopic or open operation. CONCLUSION: Defending use of antibacterial agent is according with the rules, but there are still some amendment to do in the drug use for time, drug sorts, treatment period and combined use, etc.