胃肠外科围手术期合理使用抗菌药物的探讨

Exploration of rational use of antimicrobial agents in perioperative gastrointestinal surgery

目的:探讨胃肠外科围手术期使用抗菌药物情况,指导临床合理用药。方法:总结和分析2013年2月-2014年胃肠外科治疗的220例患者的抗菌药物使用情况。结果:硝基咪唑类200例,使用率90.9%,使用率第1位。第三代头孢菌素类163例,使用率74.1%,使用率第2位。第二代头孢菌素类88例,使用率40.0%,使用率第3位。第一代头孢菌素类36例,使用率16.4%,使用率第4位。氨基糖苷类34例,使用率15.5%,使用率第5位。喹诺酮类27例,使用率12.3%,使用率第6位。第四代头孢菌素类11例,使用率5.0%,使用率第7位。青霉素类8例,使用率3.6%,使用率第8位。Ⅰ类切口单一用药10例(58.8%),二联用药6例(35.3%),三联及以上用药1例(5.9%)。Ⅱ类切口单一用药64例(32.3%),二联用药120例(60.0%),三联及以上用药16例(8.0%)。Ⅲ类切口二联用药1例(33.3%),三联及以上用药2例(66.7%)。结论:胃肠外科手术预防用药基本合理,少数用药指征把握不严,需要及时更改。

Objective:To explore the situation of antimicrobial agents used in perioperative gastrointestinal surgery to guide clinical rational drug use.Methods:The situation of antimicrobial agents used in 220 cases of patients with gastrointestinal surgery from February 2013 to 2014 were summarized and analyzed.Results:The first utilization rate was nitro imidazoles(90.9%),with 200 cases.The second utilization rate was third generation of cephalosporin(74.1%),with 163 cases.The third utilization rate was the second generation of cephalosporin(40.0% ),with 88 cases.The fourth utilization rate was nitro the first generation of cephalosporin(16.4%),with 36 cases.The fifth utilization rate was aminoglycoside(15.5%),with 34 cases.The sixth utilization rate was Quinolone(12.3%),with 27 cases.The seventh utilization rate was the fourth generation of cephalosporin(5.0%),with 11 cases. The eighth utilization rate was Penicillin(3.6%),with 8 cases.For class Ⅰ incision,there were 10 cases(58.8%) with single drug use and 6 cases(35.3%) with duplex drug use and 1 case(5.9%) with triple and more drug use.For class Ⅱ incision,there were 64 cases(32.3%) with single drug use and 120 cases(60.0%) with duplex drug use and 16 case(8.0%) with triple and more drug use. For class Ⅲ incision,there were 1 cases(33.3%) with duplex drug use and 2 case(66.7%) with triple and more drug use.Conclusion:Prophylaxis for gastrointestinal surgery was basic reasonable and the minority medicine indications was lax and needed to change timely.