荆门地区19家医院2011年腹外疝围术期预防用抗菌药物调查分析

目的:了解荆门地区医院腹外疝围术期预防用抗菌药物情况。方法:回顾性整群抽取荆门地区2011年19家医院(三级医院2所,二级医院8所,一级医院9所)腹外疝手术患者病历768份,对围术期抗菌药物应用率、抗菌药物选用频度、病原学送检率、首剂给药时间、平均给药疗程和联合用药情况进行统计、分析。结果:抗菌药物应用率三级医院达70.6%,二级医院达92.4%,一级医院达100%;人均用药种类为三级医院1.03种,二级医院1.15种,一级医院1.55种;病原学送检率三级医院为28.7%,二级医院为13%,一级医院为8.8%;首剂给药时机合理率三级医院为40.2%,二级医院为33.2%,一级医院为10%;平均给药疗程三级医院为3.5d,二级医院为4.7d,一级医院为6.2d;联合用药比例三级医院为10.1%,二级医院为31.8%,一级医院为65.9%。结论:各级医院腹外疝围术期均存在不合理应用抗菌药物的情况,二级、一级医院更为严重,亟待加强监管。

Analysis of Perioperative Prophylactic Application of Antibiotics for External Abdominal Hernia in 19 Hospitals from Jinmen Area in 2011

OBJECTIVE:To investigate the perioperative prophylactic application of antibiotics for external abdominal hernia in hospitals from Jinmen area.METHODS:768 medical records of patients underwent external abdominal hernia surgery were collected from 19 hospitals of Jinmen area(2 third-level hospitals,8 second-level hospitals,9 first-level hospitals) retrospectively.The utilization of antibiotics was analyzed statistically in respect of utilization ratio,frequency,detection rate,timing of initial dose,average treatment course and drug combination.RESULTS:The utilization ratio of antibiotics was 70.6% in third-level hospitals,92.4% in second-level hospitals and 100% in first-level hospitals;the numbers of drug types per capita were 1.03,1.15 and 1.55 kinds,respectively;the pathology detection rates were 28.7%,13% and 8.8%,respectively;the rationality of initial dose timing were 40.2%,33.2%,10%,respectively;the average treatment course were 3.5 d,4.7 d and 6.2 d;the proportions of drug combination were 10.1%,31.8% and 65.9%,respectively.CONCLUSION:Irrational use of antibiotics during perioperative period of external abdominal hernia has been found in various hospitals,especially in second and first-level hospitals.It is urgent to enhance the monitoring.