驻科药师干预创伤骨科围术期抗菌药物应用的效果分析

The Effect of Ward-based Clinical Pharmacist Interventions for Perioperative Antibiotics Use in Trauma Orthopedics

目的探讨驻科药师干预对创伤骨科围术期抗菌药物应用的效果分析,为提升临床合理应用抗菌药物及驻科药师工作模式实践提供参考。方法某院2022年10月开始在创伤骨科试行驻科药师制度。选取创伤骨科临床路径手术治疗的患者作为研究对象,以2022年1月~2022年9月的患者为对照组(n=322),2022年11月~2023年7月的患者为观察组(n=445),比较驻科药师实施药学服务干预前后的围术期预防用药相关评价指标的变化。结果观察组患者的人均住院费用、人均药品费用、人均抗菌药物费用和人均抗菌药物使用时间较对照组分别降低27.60%、22.97%、87.64%、59.38%,具有统计学意义(P<0.01),观察组患者的抗菌药物应用的不合理率为4.72%较对照组44.10%明显降低,具有统计学意义(P<0.01),同时抗菌药物使用强度由33.25 DDDs/(100人·d)降至7.97 DDDs/(100人·d);术后伤口感染发生率也明显降低。结论驻科药师参与创伤骨科围术期抗菌药物的临床实践,能促进临床抗菌药物的合理应用,降低患者的医疗负担。

OBJECTIVE To assess the effect of ward-based clinical pharmacist interventions during the perioperative period in a trauma orthopedics department,and provide insights to enhance the rational use of antibiotics in clinical practice.METHODS A ward-based clinical pharmacist system was introduced in our hospital′s trauma orthopedics department starting in October 2022.Patients undergoing surgical treatment within the clinical pathway of trauma orthopedics were selected for this study.The control group comprised patients from January 2022 to September 2022(n=322),while the observation group included patients from November 2022 to July 2023(n=445).Changes in Perioperative prophylactic medication-related evaluation indicators before and after the implementation were compared.RESULTS Patients in the observation group exhibited a statistically significant decrease in average hospitalization costs,average drug costs,average antibiotic drug costs,and average duration of antibiotic drug use by 27.60%,22.97%,87.64%,and 59.38%,respectively,compared to the control group(P<0.01).The irrational use rate of antibiotics in the observation group significantly decreased to 4.72%compared to 44.10%in the control group(P<0.01).Simultaneously,antibiotic use intensity decreased from 33.25 DDDs/(100 patient·days)to 7.97 DDDs/(100 patient·days).The postoperative surgical site infection rate also significantly decreased.CONCLUSION The implementation of ward-based pharmacists in pharmaceutical in clinical practices during the perioperative period of trauma orthopedics effectively promotes the rational use of antibiotics and reduces the medical burden on patients.