2016年解放军总医院海南分院Ⅰ类切口围手术期抗菌药物预防使用情况分析

目的 了解解放军总医院海南分院Ⅰ类切口围手术期抗菌药物预防使用情况,为规范围手术期抗菌药物预防使用和管理提供参考.方法 收集解放军总医院海南分院2016年Ⅰ类切口围手术期抗菌药物预防使用的相关数据,对用药具体情况进行分析,并对用药合理性进行点评.结果 Ⅰ类切口围手术期抗菌药物预防使用率为42.69%;其中男性高于女性,18岁以下人群使用率最高,为77.08%;脑外科手术使用率最高,达94.28%;预防用药病例数以第3代头孢菌素为主,占81.32%,以注射用头孢他啶使用人数最多,占70.23%;给药时机大于术前1 h的人数比例为61.87%;24 h内停药的患者比例为63.81%;适应症、用药品种选择、给药时机、用法用量、给药疗程及联合用药的合理率分别为73.74%、16.34%、8.56%、73.74%、63.81%和99.61%.结论 解放军总医院海南分院Ⅰ类切口围手术期抗菌药物预防使用存在使用率偏高、合理率偏低的不合理问题,尤其是品种选择及给药时机的合理性较低,应进一步规范用药和加强管理.

Analysis on prophylactic use of antibiotics in perioperative period of type I incision in Hainan Branch of PLA General Hospital in 2016

Objective To investigate the prevention use of antimicrobial agents in the perioperative period of type I incision operation in Hainan Branch of PLA General Hospital, in order to provide reference for regulating the use and management of antimicrobial agents. Methods The data of prophylactic use of antibiotics in perioperative period of type I incision in Hainan Branch of PLA General Hospital in 2016 was collected, and the situation of medication was analyzed, and the rationality of medication was discussed. Results The rate of prophylactic use of antibiotics in type I incision operation in perioperative period was 42.69%. The rate of males was higher than females. And the rate of the population under 18 was highest (77.08%). The rate of antibiotics in surgical operation was highest, up to 94.28%. The most case number of preventive drugs was the third generation cephalosporin, accounting for 81.32%, and the highest use number of antibiotics was Ceftazidime for injection, accounting for 70.23%. The proportion of administration time higher than1 h was 61.87%. The proportion of patients with drug withdrawal within 24 h was 63.81%. The rational rate of indications, variety choice, time of administration, dosage, administration course and drug combination were 73.74%, 16.34%, 8.56%, 73.74%, 63.81%, and 99.61%, respectively. Conclusion The prevention use of antimicrobial prophylaxis in type I incision operation in Hainan Branch of PLA General Hospital is unreasonable with high utilization rate and low rationality. The preventive medication should be standardized and the management should be strengthened.