药师干预对Ⅱ类切口手术预防性应用抗菌药物的影响

Impact of Pharmacist Intervention on Prophylactic Use of Antibacterial Drugs In Several Kinds of TypeⅡ Incision Operation

目的探讨药师干预对Ⅱ类切口手术预防性应用抗菌药物的影响。方法收集医院3种Ⅱ类切口手术的病历资料,分析抗菌药物预防性应用情况。通过分管领导在医院相关会议上通报、药师到临床科室实施监控等方式,对其进行干预。结果经过干预,抗菌药物的选择趋于规范化,主要以第1代头孢为主(构成比为83.58%),其次为青霉素类(构成比为14.93%);干预后单一抗菌药物使用率由干预前的90.71%上升至98.51%;术前30 min至2 h应用抗菌药物由1.33%提高至98.51%。干预前及术后抗菌药物用药时间控制在48 h内的患者有28例(12.39%),明显低于干预后的27例(40.30%)。结论临床药师对Ⅱ类切口手术抗菌药物预防性应用的合理干预,可使外科抗菌药物的使用更加规范、合理,降低治疗费用。

Objective To investigate the impact of the pharmacist intervention on prophylactic use of antibacterial drugs in several kinds of type Ⅱ incision operation. Methods The clinical data in the patients with 3 kinds of type Ⅱ incision operation （breast surgery,thyroid surgery and hernia repair） in our hospital were collected and their prophylactic use situation of antibacterial drugs was analyzed. The ways of conducting the notification in the related meetings by the leadership in charge of this work and the pharmacists going to the clinical departments for implementing the monitoring were adopted for implementing the intervention. Results After the intervention,the choice of antibacterial agents tended to be standardized,the firstgeneration cephalosporins were predominant with the constituent ratio of 83.58% ;followed by penicillins,the constituent ratio was 14.93%. The use rate of single antibacterial drug after the pharmacist intervention was increased from 90. 71% to 98.51%. The application of antibacterial drugs at 30 min to 2 h after the pharmacist intervention was increased 1.33% to 98.51%. The medication time of antibacterial drugs before intervention and after operation was controlled within 48 h in 28 cases （12.39%）,which was significantly lower that 27 cases（40.30% ） after intervention. Conclusion The clinical pharmacists＇ reasonable intervention on the prophylactic antibacterial drug use in type Ⅱ incision operation can make the surgical antibacterial drug use more standardized and more rational and reduce the treatment costs.