基层医院围术期预防性应用抗菌药物的合理性分析

目的:分析基层医院围术期预防性应用抗菌药物情况,评价用药的合理性,为临床合理用药提供参考。方法:以随机抽样法抽取2家区级医院2007年1月—2007年12月手术病例480例,对预防性应用抗菌药物的合理性进行分析与评价。结果:围术期预防性抗菌药物使用率为100%;抗菌药物中使用频率最高的前3位依次为硝基咪唑类、第3代头孢菌素、第2代头孢菌素;抗菌药物平均使用时间约为7～9 d;单一用药有242例(占50.42%),二联用药有203例(占42.29%),三联用药有24例(占7.08%),三联以上用药有11例(占0.21%)。抗菌药物持续用药时间延长,感染率并不会降低。结论:2家区级医院围术期预防性应用抗菌药物不合理情况比较严重,应在继续加强医师合理用药培训的基础上,制定具体的抗菌药物临床应用监管措施,充分发挥药师作用,提高抗菌药物应用水平。

Rationality in Perioperative Use of Prophylactic Antibiotics in Primary Hospital

OBJECTIVE: To analyze the perioperative use of prophylactic antibiotics in primary hospital and evaluate the rationality of drug use so as to provide references for clinical rational drug use.METHODS: 480 surgical cases during Jan.-Dec.2007 in two district hospitals were randomly collected for analysis and evaluation of the rationality of the utilization of the prophylactic antibiotics.RESULTS: All patients(100%) received prophylactic antibiotics during perioperative period,with nitroimidazoles,third generation cephalosporins and second generation cephalosporins used most frequently.The antibiotics were used for an average of 7 to 9 days.242(50.42%) received antibiotics of one kind,203(42.29%) of two,24(7.08%) of three and 11(0.21%) of at least three.The prolonged antibiotic use was not associated with reduced infection rate.CONCLUSION: The perioperative use of prophylactic antibiotics in the two district hospitals was quite irrational.Continued efforts should be made to tighten training on physicians about rational drug use meanwhile establishing supervisory measures on clinical use of antibiotics to bring pharmacists’ role into full play and improve the rational use of antibiotics.