2018年西安医学院附属宝鸡医院Ⅰ类切口围手术期抗菌药物预防使用合理性分析

Analysis on reasonable use of prophylactic antibacterial drugs in perioperative period of typeⅠincision in Affiliated Baoji Hospital of Xi’an Medical University in 2018

目的了解2018年西安医学院附属宝鸡医院Ⅰ类切口围手术期抗菌药物预防性使用现状,分析评价用药合理性,为抗菌药物合理性应用管理提供客观依据。方法抽取西安医学院附属宝鸡医院2018年1~12月Ⅰ类切口手术病例共872份,从适应症、品种选择、用法用量、用药时机、术中追加以及用药疗程等内容进行评价分析。结果Ⅰ类切口手术病例预防应用抗菌药物288例,使用率为33.03%;使用品种有14个,使用频率最高的是第2代头孢菌素头孢呋辛,构成比为50.68%;术前0.5~1 h给药的患者263例,合理率为91.32%;用药疗程≤24 h的患者55例,合理率为19.1%;联合用抗菌药物6例,均无联合用药指证。结论西安医学院附属宝鸡医院Ⅰ类切口围手术期预防用抗菌药物存在用药指证把握不严、药物选择不合理、用药疗程过长等问题,需加强规范管理,促进抗菌药物的合理应用。

Objective To investigate the application of prophylactic antibacterial drugs in perioperative period of type I incision in Affiliated Baoji Hospital of Xi’ an Medical University in 2018, and to analyze and evaluate the rationality of drug use, to provide basis for the rational use of antibiotics in the clinic. Methods Medical records( 872 cases) having surgery with type I incision from January to December 2018 in Affiliated Baoji Hospital of Xi’ an Medical University were selected, and indication, variety choice, administration time, course of treatment, usage and dosage, and combination of antibiotics were analyzed. Results There were 288 cases of perioperative use of antibiotics in patients with type I incision, with the application rate of 33.03%. A total of 14 types of antibiotics were used, and most of them were second generation cephalosporin cefuroxime sodium, accounting for 50.68%. The antibiotics were used 0.5 - 1 h before surgery in 263 cases with the application rate of 91.32%. The course of treatment of antibiotics was not more than 24 h in 55 cases with the application rate of 91.32%. There were 6 cases of combination of antibiotics, and there was no indication of combination therapy. Conclusion There is still existed unreasonable prophylactic application of antibiotics for type I incision, such as improper indication of drug use, inappropriate selection of drug varieties, and serious situation of combined drug use. It is necessary to further strengthen the management and continuously promote the rational use of antibiotics in the clinic.