2013-2016年上海市86所医院Ⅰ类切口围术期抗菌药物预防应用调查分析

Investigation and analysis of perioperative antibiotics prophylaxis for type Ⅰ incision surgery in 86 hospitals of Shanghai from 2013 to 2016

目的了解上海市二级甲等及以上医院外科I类切口围术期抗菌药物预防性应用的现状。方法回顾性收集上海市2013年-2016年86所不同医院I类切口围术期抗菌药物预防性使用率、用药类别、合理性及使用天数并进行综合分析。结果 2013年-2016年,上海市I类切口围术期抗菌药物预防性使用率分别为40.2%、35.7%、33.5%和32.6%,用药比例呈逐年下降趋势(P<0.001);术前用药合理比例分别为87.7%、86.8%、85.4%和89.5%,以第一代头孢和第二代头孢应用为主;术后用药时间≥24h的概率分别为33.7%、29.6%、27.7%、26.5%。结论上海市二级甲等及以上医院Ⅰ类切口围术期预防用药日趋规范,但使用类型和使用天数仍存在不合理现象,今后需加强管理促进其更加合理应用。

OBJECTIVE To investigate the current status of perioperative antibiotics prophylaxis for type I incision surgery in secondary A or above hospitals in Shanghai.METHODS From 2013 to 2016,totally 86 hospitals of Shanghai were retrospectively collected,the rate of prophylactic use of antibiotics for type I incision surgery during perioperative period,types of antibiotics used,use rationality and antibiotic treatment duration were comprehensively analyzed.RESULTS The rate of prophylactic use of antibiotics for type I incision surgery during perioperative period was 40.2%in 2013,35.7%in 2014,33.5%in 2015,32.6%in 2016,showing a downward trend（P〈0.001）.The proportion of the rational preoperative use of antibiotics was 87.7%in 2013,86.8%in 2014,85.4%in 2015,89.5% in 2016,and the first generation cephalosporins and second generation cephalosporins were the most commonly used antibiotics.The probability of postoperative use of antibiotics no less than 24 hours was33.7%in 2013,29.6% in 2014,27.7% in 2015,26.5% in 2016.CONCLUSION The perioperative antibiotics prophylaxis for type I incision surgery has become more and more standardized in the secondary A or above hospitals in Shanghai,however,the types of antibiotics used and antibiotics treatment duration remain unreasonable,and it is necessary to strengthen the management so as to make the use of antibiotics reasonable.