摘要
本研究评估了临床药师干预前后某大医院甲状腺手术预防性抗菌药物的使用情况。自2004年至2012年,随机抽取每年的70例接受甲状腺手术的患者病历,评价干预前后手术预防性应用抗菌药物的合理性。研究结果表明,从2004年到2010年抗菌药物使用率一直是100%。实施干预后,2011年使用率降到45.7%,2012年降到2.9%。2010年之前的AUD一直大于38,2012年迅速下降到1。每100个手术的DDDs由干预前的143降至3。2010年抗菌药物的平均费用为350.65元,2012年降至18.51元。干预前后患者平均住院天数没有区别。结果表明,临床药师的干预和专项整治的实施能改善围手术期抗菌药物的合理使用。
In the present study, we aimed to evaluate the intervention effect of prophylactic antibiotic use in thyroid surgery in a large hospital. From 2004 to 2012, 70 patients who underwent thyroid surgery were randomly selected each year. The quality of surgical antibiotic prophylaxis （SAP） was assessed each year in terms of antibiotic ratio, choice, duration, timing, combination, route of administration and so on. The result showed that the SAP ratio was 100% from 2004 to 2010. With our intervention, this SAP ratio was decreased to 45.7% in 2011, and it reached 2.9% in 2012. The AUD was consistently greater than 38 before 2010, while it rapidly declined to 1 in 2012. The number of DDDs per 100 operations was decreased from 431 to 3 after the intervention. The average cost of antibiotic drugs per patient was RMB 350.65 in 2010, whereas it was decreased to RMB 18.51 in 2012. The average duration of hospitalization showed no difference during the intervention. This study indicated that implementation of a multi-disciplinary protocol and clinical pharmacist interventions could improve the rational use of SAP.
