规范使用抗菌药物前后四肢闭合性骨折I类切口手术患者合理用药情况调查

Investigation of reasonable antibiotics application for closed fractures of the extremities with type I incision before and after rational use

目的调查《抗菌药物临床应用规范及管理实施细则》的实施对四肢闭合性骨折I类切口手术患者用药合理率的影响。方法从用药指征、用药种类、给药时机、用药疗程、术后感染率等方面考察2010年1月至2014年12月共348例四肢闭合性骨折I类切口手术患者。结果实施前组用药指征、抗菌药物种类选择、给药时机、用药疗程合理率分别为100％、11．70％、100％、5．84％，术后感染率为2．34％；实施后组用药指征、抗菌药物种类选择、给药时机、用药疗程合理率分别为100％、93．22％、100％、58．76％，术后感染率为1．70％。两纽用药指征合理率、给药时机合理率、术后感染率比较差异均未见统计学意义（P〉0．05）；两组抗菌药物选择合理率、用药疗程合理率比较差异有统计学意义（P〈0．05）。结论《抗菌药物临床应用规范及管理实施细则》实施后，预防性使用抗菌药物合理率有所提高，在未增加感染率的前提下，显著提高了药物选择合理率、用药疗程合理率。

Objective To investigate the influence of the guideline for clinical use of antibiotics to the rate of reasonable antibiotics application of the patients with closed fractures of the extremities with type I incision. Methods Investigated the 348 patients with closed fractures of the extremities with type I incision from 2010 to 2014 by recording the indications, the description, the timing administration, the course and the rate of infection. Results The reasonable rate of the indications, the description, the timing administration and the course were 100% , 11.70% , 100% and 5.84% before the guideline was carried out. While were 100% , 93.22% , 100% and 58.76% after the guideline was carried out. The rate of infection was 2. 34% before the guideline was carried out, while was 1.70% after the guideline was carried out. The reasonable rate of the indications, the timing administration and the rate of infection had no significant difference before and after the guideline was carried out. While the reasonable rate of the description and the course had significant difference before and after the guideline was carried out. Conclusions The reasonable rate of antibiotics application in orthopedics had improved after the guide- line was carried out. The reasonable rate of the description and the course were improved significantly without improving the rate of infection.