我院外科围手术期抗菌药物使用情况分析

Analysis of use of antibiotics in the perioperative period of surgery in our hospital

目的 分析本院外科围手术期抗菌药物使用情况,为临床抗菌药物合理使用提供参考依据。方法 选择本院外科出院的手术病例243例,查阅患者病历资料,分别对围手术期抗菌药物的品种选择、给药时间、给药剂量、用药疗程、联合用药情况进行分析。结果 243例外科手术患者中,使用抗菌药物的患者有205例,使用率为84.36%。其中阑尾切除术抗菌药物使用率为92.86%、关节置换术抗菌药物使用率为86.25%、骨内固定术抗菌药物使用率为73.42%;Ⅰ类切口抗菌药物使用率为83.25%、Ⅱ类切口抗菌药物使用率为89.13%。205例抗菌药物使用患者中, 32例使用不合理,占比为15.61%。其中:用药时机不当占比为34.38%、无指征预防用药占比为31.25%、用药时间过长占比为25.00%、抗菌药物选择不适宜占比为9.38%。205例外科围手术期使用抗菌药物的患者中,涉及的抗菌药物品种共有12个,其中使用频率最高的为头孢唑肟(34.63%),其次为头孢他啶(13.66%)和头孢曲松(13.17%)。结论 本院外科围手术期抗菌药物使用不合理现象明显,主要表现为Ⅰ类切口抗菌药物使用率高、用药时机不当、无指征预防用药、用药时间过长、抗菌药物选择不适宜等,应强化临床医师合理使用抗菌药物意识,加强抗菌药物管理,提高抗菌药物合理使用水平,从而建立健全合理使用抗菌药物的管理制度。

Objective To analyze the use of antibiotics in the perioperative period of surgery in our hospital, so as to provide reference basis for the rational use of antibiotics in clinic. Methods 243 surgical cases discharged from the hospital were selected. The patient’s medical records were reviewed to analyze the selection of perioperative antibiotics, administration time, dosage, duration of medication, and combined medication. Results Among the 243 surgical patients, 205 patients used antibiotics, and the utilization rate was 84.36%. Among them, 92.86% of the patients used antibiotics for appendectomy, 86.25% for joint replacement, 73.42% for bone fixation, 83.25% for class Ⅰ incision, and 89.13% for class Ⅱ incision. 32 of the 205 patients used antimicrobial drugs, accounting for 15.61%. Of the 205 patients who used antibiotics, 32 cases used them unreasonably,accounting for 15.61%. Among them, the proportion of inappropriate drug use was 34.38%, the proportion of nonindicated preventive drug use was 31.25%, the proportion of prolonged drug use was 25.00%, and the proportion of inappropriate selection of antibiotics was 9.38%. Among 205 patients who used antibacterial drugs during perioperative period, there were 12 kinds of antibiotics involved, among which ceftizoxime(34.63%) was the most frequently used, followed by ceftazidime(13.66%) and ceftriaxone sodium(13.17%). Conclusion The irrational use of antibiotics in the perioperative period of surgery in our hospital is obvious, which is mainly manifested in the high use rate of class Ⅰ incision antibiotics, inappropriate drug use, non-indicated preventive drug use, prolonged drug use, inappropriate selection of antibiotics. It is necessary to strengthen clinicians’ awareness of rational use of antibiotics, strengthen the management of antibiotics, improve the level of rational use of antibiotics, so as to establish and improve the management system of rational use of antibiotics.