我院2013年Ⅰ类切口手术围术期抗菌药物预防使用分析

Analysis of Perioperative Prophylactic Use of Antibiotics for TypeⅠIncision Operation in Our Hospital 2013

目的：为围术期抗菌药物的合理预防使用提供参考。方法：抽取我院2013年1-12月Ⅰ类切口手术出院病历2 421份,进行围术期预防用药的回顾性调查,分析抗菌药物使用率、给药时机、用药疗程及其具体不合理使用情况等。结果：Ⅰ类切口手术围术期预防使用抗菌药物的患者有439例,占18.13%。其中,第一代头孢菌素使用率为81.65%（356/439）,林可霉素类使用率为7.57%（33/439）。术前0.5-2 h抗菌药物的使用率为97.27%（427/439）。用药疗程控制在术后48 h内的病例占60.36%（265/439）。不合理用药率为10.57%（256/2 421）,包括用药疗程过长（7.18%）、抗菌药物选择不合理（2.02%）、用法用量不合理（0.50%）、给药时机不合理（0.50%）、无适应证用药（0.37%）。结论：我院Ⅰ类切口手术围术期抗菌药物的预防使用基本合理,但仍存在不重视适应证、药物选择不合理、用药疗程过长等问题,尤其还存在多种不合理现象同时出现的情况。

OBJECTIVE： To provide reference for the rational perioperative prophylactic use of antibiotics. METHODS： Total- ly 2 421 cases with type I incision operation in our hospital during Jan.-Dec. 2013 were collected and retrospectively analyzes the utilization rate, administration time, medication course and specific irrational use. RESULTS： There were totally 439 patients with perioperative prophylactic use of antibiotics in type I incision operation, accounting for 18.13%. The utilization rate of first-generation cephalosporins was 81.65% （356/439） and the clindamycin was 7.57% （33/439）. The rate of antibiotics within 0.5-2 h before operation was 97.27% （427/439）. 60.36% （265/439） of antibiotic treatment was finished within 48 h after operation. The irrational drug use rate was 10.57% （256/2 421） , including long course of treatment （7.18%） , unreasonable selection of antibiotics （2.02%） , unreasonable usage and dosage （0.50%） , unreasonable administration time （0.50%） and no drugs for indication （0.37 % ）. CONCLUSIONS： The perioperative prophylactic use of antibiotics for type I incision operation in our hospital is basically raional, however, there were still irrationalities, including take no account of indication, irrational drug selection, too long medi- cation course, etc. especially, various irrationalities happen at the same time.