2016—2017年郑州市妇幼保健院剖宫产术围手术期预防用抗菌药物合理性分析

Analysis on reasonable use of prophylactic antibacterial drugs in cesarean section operations in Women and Infants of Zhengzhou from 2016 to 2017

目的分析2016年1月—2017年12月郑州市妇幼保健院剖宫产术围手术期抗菌药物预防用药的使用情况,为进一步规范抗菌药物合理应用提供参考。方法对2016年1月—2017年12月郑州市妇幼保健院剖宫产术围手术期预防用抗菌药物的使用情况进行回顾性调查,评价其合理性。结果 2 379例患者预防用抗菌药物共涉及10个品种,头孢呋辛、甲硝唑和头孢唑啉的使用频次居前3位。99.5%的手术术前0.5~1.0 h给药。用药维持时间以24、48 h为主,构成比分别为48.6%、50.4%。联合用药主要表现为头孢呋辛+甲硝唑,构成比为96.1%。不合理用药表现形式主要有用药维持时间长(44.1%)、品种选择不当(24.2%)、用药指征把握不严(18.3%)等。结论郑州市妇幼保健院剖宫产术围手术期预防用抗菌药物使用基本合理,但仍存在不合理用药现象,应加强监督管理。

Objective To evaluate the use of antibacterial drugs in cesarean section operations in Women and Infants Hospital of Zhengzhou from 2016 to 2017, and to provide reference for the further application of antibacterial drugs. Methods The use of prophylactic antibacterial drugs in cesarean section operations in Women and Infants Hospital of Zhengzhou from January 2016 to December 2017 were analyzed statistically, and the rationality was evaluated. Results There were 2 379 cases of patients using prophylactic antibacterial drugs including 10 breeds. The use of efuroxime, metronidazole, and cefazolin were ranked the top three. The most time administration of antibacterial drugs was 0.5 — 1.0 h, accounting for 99.5%. The main medication maintaining time of antibacterial drugs were 24 and 48 h, accounting for 48.6% and 50.4%, respectively. The main drug combination of antibacterial was cefuroxime combined with metronidazole, accounting for 96.1%. The main types of unreasonable medicine were the prolonged medication duration（44.1%）, inappropriate choice of medicine（24.2%）, and non-strict mastering indications of the medication indication（18.3%）. Conclusion The use of prophylactic antibacterial drugs in cesarean section operations in Women and Infants Hospital of Zhengzhou is basically rational. But there are still some irrational usages of antibacterial drugs, which needs further efforts to strengthen the management.