合理干预前后5种清洁手术围术期预防性应用抗菌药物分析

Analysis of the Perioperative Use of Prophylactic Antibiotics in Patients Undergoing 5 Aseptic Operations before and after Intervention on the Rational Use of Antibiotics

目的:了解某院5种清洁手术围术期预防性使用抗菌药物情况与干预措施的实施效果。方法:对该院2011年第一季度、2012年第一季度、2013年第一季度5种清洁手术(乳腺手术、甲状腺手术、腹股沟疝手术、介入手术、膝关节镜手术)患者的围术期预防性使用抗菌药情况进行调查分析。结果:与干预前相比,第二阶段干预后该5种清洁手术预防性使用抗菌药物比例从92.7%下降到8.5%,预防性使用抗菌药物的合理率从4.0%升高到19.4%,合理干预成绩可喜。在给药剂量、给药途径、药物品种选择、术中追加方面已基本实现100%合理,但在预防性使用抗菌药物适宜情况审视、术前给药时机及预防性使用抗菌药时间等方面仍存在多例不合理现象,致使预防性使用抗菌药物的合理率仍不让人满意。结论:该院对围术期抗菌药物应用采取干预措施取得了一定成效,为进一步促进合理用药提供了一个有效可行的模式,但离原卫生部规定的要求仍存在一定差距,应继续加强监管。

OBJECTIVE：To investigate the perioperative use of prophylactic antibiotics in patients undergoing five different aseptic operations in a hospital and evaluate the efficacy of the intervention on perioperative use of prophylactic antibiotics.METH-ODS：The perioperative use of prophylactic antibiotics for patients undergoing different aseptic operations（breast surgery,thyroid surgery,inguinal hernia surgery,interventional surgery or knee arthroscopy） in a hospital in the first quarters from 2011 to 2013 were analyzed. RESULTS：After intervention of two phases,the perioperative use of prophylactic antibiotics in patients undergoing five different aseptic operations in a hospital decreased from 92.7%to 8.5%and the rational rate of the perioperative use of prophy-lactic antibiotics raised from 4.0% to 19.4%,indicating that a remarkable outcome for the intervention has been achieved. Rational rates in singe dose,route of administration,drug selection or intraoperative addition of antibiotics etc reached 100%. However, the suitability of antibiotic use and the time and duration of antibiotic use in several cases were irrational which resulted in unsatis-factory rational rate in the use of prophylactic antibiotics. CONCLUSIONS：The intervention measures on the perioperative use of prophylactic antibiotics have achieved certain efficacy,which provides an effective and feasible model for rational drug use;howev-er,there is a long way to go before meeting the standard of Ministry of Health.It is necessary to strengthen supervision on the anti-biotic use.