干预前后清洁手术围术期抗感染药物使用状况分析

目的:评价临床药师干预清洁手术围术期预防性使用抗菌药物的效果。方法:某"三甲"医院临床药师依据该院围术期抗菌药物预防使用规范,对病区清洁手术预防用药过程进行干预。将2011年7-8月实施临床药师干预的509例患者作为干预组,2010年7-8月未实施临床药师干预的495例患者为未干预组,比较干预前后抗菌药物使用的合理性状况、用药频度(DDDs)、抗菌药物费用。结果:抗菌药物使用的合理率由未干预组的55.96%上升至干预组的67.58%(P<0.01);抗菌药物种类由未干预组的51种降至干预组的35种;干预组第1、2代头孢菌素使用增多,第3代及3代以上头孢菌素使用减少,与未干预组比较差异有统计学意义(P<0.05);干预组二、三线抗菌药物DDDs的降低也使得药品费用有了显著性下降(P<0.05)。结论:临床药师的干预提高了清洁手术围术期抗菌药物使用的合理性,改善了抗菌药物的使用状况。

Analysis of Perioperative Utilization of Anti-infective Drugs in Clean Operations before and after Intervention

OBJECTIVE： To evaluate the effect of perioperative prophylactic application of antimicrobial drugs in clean opera tions by clinical pharmacist＇s interventions. METHODS： Clinical pharmacists intervened in medication duration of clean surgery ac- cording to the standards for perioperative prophylactic application of antimicrobial drugs in a third-grade class-A hospital. 509 pa tients receiving pharmacist intervention from Jul. to Aug. in 2011 were included in intervention group, and 495 patients without re ceiving pharmacist intervention from Jul. to Aug. in 2010 were included in non-intervention group. The rationality condition, DDDs and costs of the antimicrobial drugs were compared before and after the intervention. RESULTS ： Rational use rate of antimicrobial drugs increased from 55.96% to 67.58% after intervention （P~0.01） ; the types of antimicrobial drugs reduced from 51 kinds to 35 kinds, the use of first and second-generation cephalosporin increased while the use of third-generations or above cephalosporin decreased （P〈0.05） ; the decrease of the frequency of second and third-line antimicrobial drugs promoted the decrease of drug costs （P〈0.05）. CONCLUSIONS： The clinical pharmacist＇s intervention can improve the rationality of perioperative utilization of antimicrobial drugs in clean surgerv, as well as improve the utilization of antimicrobial drugs.