广西地区10家三级甲等医院3种清洁手术预防用抗菌药物干预研究

目的:建立3种清洁手术预防用抗菌药物的干预模式,有效控制抗菌药物不合理应用。方法:对广西地区10家三级甲等医院3种清洁手术干预前、后预防用抗菌药物情况进行合理性评价及统计学分析,建立适合本地区有效的、具可操作性的干预措施。结果:经过3个阶段干预,抗菌药物应用率降至62.55%,合理应用率显著提高,达到49%,平均用药疗程由5.29d降至1.92d,平均抗菌药物费用明显下降。干预后抗菌药物应用范围降为4类20种,头孢唑林出现的频次明显升高(P<0.05)。经3轮干预后,预防用药在术前0.5～2h给药例数所占比例逐渐增多,平均抗菌药物费用明显下降,抗菌药物不合理应用情况得到明显改善。结论:本研究可为促进抗菌药物合理应用提供科学、有效的管理模式。

Intervention Research of the Perioperative Prophylactic Application of Antibacterials for 3 Types of Clean Operations in 10 Class 3 Grade A Hospitals from Guangxi Area

OBJECTIVE：To establish intervention model of the perioperative prophylactic application of antibacterials for 3 types of clean operations,which can effectively control the irrational use of antibacterials.METHODS：The rationality of antibacterials use in 3 clean surgeries before and after intervention in 10 class 3 grade A hospitals was evaluated and analyzed statistically,and the effective and operative intervention measures were established according to the condition of the region.RESULTS：After the 3 phases of intervention,the utilization ratio of antibacterials reduced to 62.55%,reasonable use rate increased significantly to 49%.Average medication duration decreased from 5.29 d to 1.92 d,and average antibacterial drug costs decreased significantly.After the intervention,antibacterials used reduced to 20 kinds of 4 major categories,the frequency of cefazolin increased significantly（P〈0.05）.After 3 cycles of intervention,the proportion of preventive medication 0.5～2 h before operation gradually increased.Average antibacterials cost decreased significantly,and irrational uses of antibiotics were improved obviously.CONCLUSION：The research provides a scientific and effective management mode for promoting rational use of antibacterials.