临床药师干预口腔颌面外科围手术期抗菌药物的应用

Intervention in the application of antimicrobials in oral and maxillofacial surgery by clinical pharmacists during perioperation

目的:综合分析南京大学医学院附属口腔医院口腔颌面外科住院病人抗菌药物的使用情况,探讨临床药师对临床抗菌药物合理性应用进行干预所起的作用,为临床合理用药提供参考。方法:随机抽取本院2011年7-12月未经临床药师干预使用抗菌药物的100份出院病人病历作为非干预组,再分别随机抽取2012年7-12月和2013年7-12月经临床药师干预后使用抗菌药物的100份出院病人病历作为干预组,对围手术期使用抗菌药物的合理性进行比较。结果:经过临床药师干预后本院口腔颌面外科在围手术期病人的用药适应证、抗菌药物选择、用法用量、术前给药时机、用药疗程、联合用药等方面较干预前有明显的改善。结论:通过临床药师的合理化干预,使本院抗菌药物治疗方案更加趋于规范。临床药师需不断提高自身业务水平,加强相关专业知识的学习,在提高医院医疗质量、保障病人用药安全和降低医药费用等方面起到有效的推进作用。

Objective： To comprehensively analyze the application of antimicrobials in patients with oral and maxillofacial surgery in the Stomatological Hospital Affiliated to Medical College of Nanjing University, and also to discuss the role of clini- cal pharmacists in clinical intervention regarding clinical application of antimicrobials, so as to provide reference for rational ap- plication of drugs. Methods： One hundred medical records of the discharged patients treated with antimicrobials from July to December 2011, without clinical pharmacist intervention were randomly selected from the medical files of our hospital and were designated as the non-intervention group. Another 100 medical records of the discharged patients treated with antimierobial treatment from July to December 2012 and at the same time span of next year with clinical pharmacist intervention were as- signed as the intervention group. Rationality in the use of antimicrobials during perioperation was compared between the 3 groups. Results： With regard to the rationahty in the use of antimicrobials in oral and maxillofacial surgery in our hospital dur- ing perioperation, medication indications, choice of antimicrobials, dosage, time of medication before surgery, course of medi- cation, and combined medication in the intervention groups were all obviously improved after intervention. Conclusion： Follow- ing proper intervention of clinical pharmacists, the use of antimicrobials in our hospital tended to be more standardized. How- ever, efforts should be made on the part of clinical pharmacists to improve their professional knowledge and work proficiency, and there was a more important role for clinical pharmacists to play in further improvement of quality medical care, assurance of medication safety, and reduction of medical costs in the hospital.