我院全国抗菌药物临床应用监测网直报Ⅰ类切口手术围术期预防使用抗菌药物情况点评分析

The use of antibacterials in the perioperative prevention of class Ⅰ incision surgery in our hospital reporting to national antibacterial drug clinical application monitoring network

目的分析我院Ⅰ类切口手术围术期预防使用抗菌药物情况,为临床进一步规范抗菌药物合理应用提供参考。方法对2016年1月～2018年3月我院于全国抗菌药物临床应用监测网合计上报的169例住院手术患者Ⅰ类切口预防使用抗菌药物品种、用药时机、科室使用等情况进行统计分析。结果在上报的169例Ⅰ类切口手术围术期中预防使用抗菌药物比例为36.69%,超过30%的规定。其中术前0.5～2h给药34例,预防使用时机选择合理占比为54.84%;通过整治降低了患者感染几率和程度,减少患者经济负担,平均使用抗菌药物天数较专项整治之前减少至4.8d;头孢呋辛、头孢唑啉钠使用居前,抗生素选择符合规定;无感染征变换抗菌药物现象得到一定遏制,未出现联合使用两种及以上抗菌药物的现象。结论我院Ⅰ类切口手术围术期预防使用抗菌药物仍存在不合理现象,医院需要积极发挥临床药师用药干预作用,建立健全抗菌药物监管体制。

Objective To analyze the use of antibacterials in the perioperative prevention of class Ⅰ incision surgery in our hospital,and to provide reference for further standardizing rational use of antibiotics in clinic.Methods Statistical analysis was made on 169 cases with class Ⅰ incision prophylactic use of antibacterials in our hospital from January 2016 to March 2018,which were reported to the national antibacterial drug clinical application monitoring network.Results The prophylactic use of antibacterials in the perioperative period of 169 reported cases with class Ⅰ incision was 36.69%,which exceeded 30%.34 patients were administered drug 0.5 to 2 hours before surgery,the reasonable time of prophylactic use was 54.84%.Patients'infection probability and degree were decreased and financial burden were reduced through the regulation,average days of antimicrobial use decreased to 4.8 days compared with before special rectification.Cefuroxime,cefazolin sodium were used first,antibiotic selection met the requirements.The phenomenon of changing antibacterials without infection sign had been curbed to a certain extent,and there was no phenomenon of using two or more antibacterials in combination.Conclusion There are still unreasonable phenomena in the prophylactic use of antibacterials during perioperative period of class Ⅰ incision operation in our hospital.Hospital needs to make clinical pharmacists play an active role in drug intervention,and establish and improve the supervision system of antibacterials.