循证药学干预儿童尿道下裂围术期抗菌药物预防性应用效果评价

Effect of Evidence-Based Pharmacy Intervention on the Perioperative Prophylactic Use of Antibiotics in Children with Hypospadias

目的探讨循证药学在儿童尿道下裂围术期抗菌药物预防性应用中的指导作用。方法选取医院2019年7月至2020年7月收治的尿道下裂住院患儿176例,按随机数字表法分为观察组和对照组,各88例。观察组按循证药学方法制订围术期预防用药方案,对照组按经验预防使用抗菌药物,两组抗菌药物均选用五水头孢唑林,药品信息及使用条件、方法均一致。结果观察组患儿导尿管留置时间为(9.42±1.25)d,明显短于对照组的(11.62±1.32)d(P=0.001);观察组与对照组患儿尿路感染发生率相当(2.27%比4.55%,P=0.406),不良反应发生率相当(1.14%比3.41%,P=0.097);观察组患儿抗菌药物预防用药维持时间为(4.56±1.01)d,明显短于对照组的(6.58±1.12)d(P=0.001);观察组患儿抗菌药物费用为(425.8±25.6)元,住院费用为(9077.51±125.6)元,住院天数为(9±1.32)d,明显优于对照组的(817.13±39.6)元、(11009.10±210.23)元、(10±1.67)d(P=0.001)。结论循证药学干预可使尿道下裂患儿围术期预防性应用抗菌药物更规范、合理,可降低术后尿路感染发生率及药品不良反应发生率,并减少住院费用。

Objective To investigate the guiding role of evidence-based pharmacy in the perioperative prophylactic use of antibiotics in children with hypospadias.Methods A total of 176 hospitalized children with hypospadias admitted to our hospital from July 2019 to July 2020 were selected and divided into the observation group and the control group by the random number table method,88 cases in each group.The children in the observation group were given the perioperative prophylactic drug regimen by the evidence-based pharmacy method,while the children in the control group were given the prophylactic use of antibiotics according to experience.Cefazolin pentahydrate was used in both groups,and the drug information,use conditions and methods in both groups were the same.Results The postoperative indwelling time of urinary catheter in the observation group was(9.42±1.25)d,which was significantly shorter than(11.62±1.32)d in the control group(P=0.001).The incidence of urinary tract infection in the observation group was similar to that in the control group(2.27%vs.4.55%,P=0.406).The incidence of adverse reactions in the observation group was similar to that in the control group(1.14%vs.3.41%,P=0.097).The maintenance time of prophylactic use of antibiotics in the observation group was(4.56±1.01)d,which was significantly shorter than(6.58±1.12)d in the control group(P=0.001).The cost of antibiotics,the hospitalization expense and the length of hospital stay in the observation group were(425.8±25.6)CNY,(9077.51±125.6)CNY and(9±1.32)d respectively,which were significantly better than(817.13±39.6)CNY,(11009.10±210.23)CNY,(10±1.67)d in the control group(P=0.001).Conclusion Evidence-based pharmacy intervention can promote the perioperative prophylactic use of antibiotics more standardized and reasonable,reduce the incidence of postoperative urinary tract infection and adverse drug reactions,and hospitalization expense.