持续干预措施对我院Ⅰ类切口手术预防抗菌药物的影响

Influences of Sustained Intervention on Clinical Effects of Preventive Antibiotics for TypeⅠIncision in Our Hospital

目的 探讨抗菌药物临床应用专项整治活动综合干预措施对Ⅰ类切口手术预防用药合理应用的成效。方法 随机抽取我院2010-2013年Ⅰ类切口手术病历,对干预前后Ⅰ类切口抗菌药物使用率,药物选择,联合用药,术前用药时机和术后持续时间等进行对照分析。结果 经持续干预,Ⅰ类切口手术预防用药合理性显著提高。抗菌药物使用率和联合用药分别由干预前的100%和34.44%下降至49.44%和2.25%,术前用药时机和术后持续时间的不合理分别由原来的32.22%和85%均下降到2.22%,抗菌药物的选择由干预前以β-内酰胺类含酶抑制剂和第三代头孢菌素为主,到干预后以第二代头孢菌素预防为主。结论 我院Ⅰ类切口手术预防用药趋于合理,干预措施有效可行。但仍存在预防使用率偏高现象,需进一步加强监理力度,促进围术期抗菌药物的合理使用。

Objective To investigate the clinical effects of comprehensive intervention measures on rational preventive utilization of antibiotics for type I surgical incision after a special improving campaigns. Methods Medical records of type I surgical incisions from 2010 to 2013 in our hospital were randomly selected. A before and after comparison was performed on the data including utilization rate of antibiotics on type I incision, drug selection, drug combination, drug administration time before surgery and duration time after surgery. Results After the sustained intervention, rational preventive utilization of antibiotics for type I surgical incision was improved significantly. Antimicrobial utilization rate and combination utilization decreased from 100% and 34.44% before the intervention to 49.44% and 2.25%respectively. The irrational rate of drug administration time before operation and duration time after operation decreased from 32.22%and 85%to 2.22%respectively. The selection spectrum of main antibiotics di verted from β-lactam containing enzyme inhibitors and third-generation cephalosporins before intervention to sec ond-generation cephalosporins after intervention. Conclusion The utilization of preventive antibiotics for type I surgical incision in our hospital is rationalized, and the intervention measures are effective and feasible. But the preventive utilization rate is still high. The further measures on the supervision should be adopted to promote the rational utilization of perioperative antimicrobial drugs.