7086例Ⅰ类切口手术抗菌药物预防性使用情况

Preventive Use of Antibiotics in Type Ⅰ Incision Surgery in 7086 Patients

目的调查Ⅰ类切口手术围手术期抗菌药物预防性使用情况,考察临床药师干预效果,为临床合理用药提供参考。方法收集西双版纳州人民医院2016—2018年总计7086例Ⅰ类切口手术,对抗菌药物预防使用率、给药时机、疗程以及品种选择等方面进行分析。结果2016—2018年,Ⅰ类切口手术的抗菌药物预防使用率从12.73%降至8.44%;术前0.5~1 h给药率从89.90%升至97.11%;用药疗程>48 h比例从28.20%降至4.96%;一、二代头孢使用比例从66.54%升至83.06%。不合理用药情况主要集中在骨科、疼痛科等科室。结论通过临床药师有效干预,Ⅰ类切口手术围手术期预防性应用抗菌药物合理性得到了显著改善,但仍有不足,需继续加强监督。

Objective To explore the preventive use of antibiotics in TypeⅠincision surgery in perioperative period,to investigate the effects of clinical pharmacist intervention and to provide a reference for clinical rational drug use.Method A total of 7068 cases of TypeⅠincision surgery in People’s Hospital of Xishuangbanna Autonomous Prefecture during 2016-2018 were collected.And the preventive use rate of antibiotics,the timing of administration,the course of treatment etc.were comprehensively analyzed.Results From 2016 to 2018,the preventive use rate reduced from 12.73%to 8.44%;the preoperative administration rate(0.5-1 h)elevated from 89.90%to 97.11%;the proportion of medication course(>48 h)reduced from 28.20%to 4.96%;the first and the second generation cephalosporins use rate elevated from 66.54%to 83.06%.Irrational drug use existed mostly in departments of orthopedics and pain etc.Conclusion Through effective intervention by clnical pharmasict,the rational prophylactic use of antibiotics in TypeⅠincision surgery in perioperative period has been significantly improved.But there is still some deficiencies,which needs more continuous regulations.