清洁手术预防应用抗菌药物调查

Investigation on preventive application of antibiotics in clean surgery

目的探讨2016~2017年我院清洁手术围手术期预防应用抗菌药物的情况,为临床合理使用抗菌药物提供参考。方法采用回顾性方法,对我院2016年1月~2017年12月共1170例清洁手术抗菌药物的使用情况进行分析。结果 1170例清洁手术中,动静脉瘘手术占比最大,为60.43%;抗菌药物预防性使用率为9.74%;预防性应用抗菌药物涉及4类,以β-内酰胺类为主;清洁手术预防用抗菌药物平均使用天数为1.44d,预防用药时长在24h以内的占78.07%;预防应用抗菌药物不合理情况以药物选择不当为最多,占57.87%。结论我院清洁手术围手术期应用抗菌药物存在药物选择不当、用药时间过长、给药时机不当、无指征用药等问题,医院应加强管理,采取多种措施规范抗菌药物的使用。

Objective To explore the situation of preventive application of antibiotics in perioperative period of clean surgery in our hospital during the past 2016-2017 years, so as to provide reference for clinical rational use of antibiotics. Methods From January 2016 to December 2017, the application of antibiotics was retrospectively analyzed in 1170 cases of clean surgery in our hospital. Results The proportion of arteriovenous fistula surgery was 60.43% in 1170 cases of clean surgery, which took the largest proportion;The rate of preventive application of antibiotics in the clean surgery was 9.74%;There were 4 types of prophylactic antibiotics, mainly beta lactam. The average time of preventive application of antibiotics in the clean surgery was 1.44 days and the proportion of preventive medication was less than 24 hours, accounting for 78.07%. Inappropriate selection of antibiotics was commonly manifested in the irrational preventive use of antibiotics, which accounted for 57.87%. Conclusion During the perioperative period, there are irrational situation in our hospital including inappropriate selection of antibiotics, lengthy drug administration time, unsuitable opportunity for administration and antibiotics without indication of medicine, etc. Our hospital should strengthen the management of antibiotics and take a variety of measures to regulate the clinical use of antibiotics.