3种清洁手术抗菌药物预防使用情况调查

目的了解本院腹外疝、甲状腺和乳房3种清洁手术抗菌药物预防使用情况。方法回顾性调查手术科室2010年5至12月住院患者的病历,包括患者的基本情况、手术类型、抗菌药物的品种、给药途径、疗程和费用等,并与指南比较和分析。结果共266份病历,病人年龄2～88岁(中位数:52岁)。头孢呋辛是最常预防使用的抗菌药物。不合理用药主要为给药时机不当、术后用药时间过长、药物选择、用药频度及溶媒不当等。结论医院应该建立和完善清洁手术围手术期抗菌药物预防使用的管理制度,加强对医务人员的培训,促使临床合理用药。

Surveillance of antibiotic prophylaxis for patients undergoing three kinds of clean surgical procedure

Objective To collect some information on antibiotic prophylaxis for patients undergoing clean surgical procedure such as inguinal hernia repair,thyroidectomy and breast surgery in a hospital.Methods Retrospectively surveyed with medical record about antimicrobial prophylaxis for in-patients in surgerical department between May and Dec in 2010.We recorded information about gender and age of patients,types of operations,appropriate of antimicrobial choice,administration,duration and cost,and complied with guidelines.Results Two hundred and sixty-six records were reviewed,patients aged from 2 to 88 years old(median: 52 years).Cefuroxime was the most frequently used antibiotics.Major irrationally antimicrobial prophylaxis were improper timing,duration,excess postoperatively use,inappropriate drug selection,frequency and infusion diluents.Conclusion Strategies should be made to standardize the duration of peroperation antibiotic use,restricting antibiotic prophylaxis for clean operation and medical satffs trained to promote rational prophylaxis in clinical practice.