我院骨折内固定术围术期预防性应用抗菌药物调查分析

目的:对我院抗菌药物专项整治活动前后骨折内固定术围术期预防性应用抗菌药物情况进行调查,为临床围术期合理使用抗菌药物提供参考。方法:记录我院2011年1-7月和2013年1-7月择期行骨折内固定术的全部患者信息,采用随机数字表法分别抽出200份病历,其中前者纳入整治前组(非干预组),后者纳入整治后组(干预组)。对两组患者预防性应用抗菌药物的情况进行统计、分析。结果:整治后预防性应用合理性明显提高,预防用药率由100%下降至29%;用药时机合理率由0上升至100%;预防用药疗程也明显缩短,平均用药时间由5.12 d缩短至1.89 d。但整治前后的术后切口感染率差异无统计学意义(P>0.05)。结论:抗菌药物专项整治活动显著促进了我院择期骨折内固定术的预防用药的合理性,但该项管理工作仍需常态化,临床药师需继续积极参与抗菌药物监管工作,尽可能地减少不合理用药。

Investigation and Analysis of Perioperative Prophylactic Application of Antibiotics in Internal Fixation of Fracture in Our Hospital

OBJECTIVE： To investigate perioperative the prophylactic application of antibiotics in internal fixation of fracture in our hospital before and after special rectification, and to provide reference for rational use of antibiotics. METHODS： Medical in- formation of patients underwent internal fixation of fracture were recorded in our hospital from Jan. to Jul. 2011 and from Jan. to Jul. 2013. 200 medical records were selected randomly and divided into before rectification group （non-intervention group, in 2011） and after rectification group （intervention group, in 2013）. The prophylactic application of antibiotics was analyzed statisti- cally in 2 groups. RESULTS： After rectification, the rationality of prophylactic application had been improved significantly, and the rate of prophylactic medication decreased from 100% to 29%. The rationality of medication timing increased from 0 to 100%. The duration of prophylactic medication had been shortened significantly, and average medication duration decreased from 5.12 days to 1.89 days. There was no significant difference in postoperative infection rate before and after rectification （P〉0.05）. CON- CLUSIONS： The antibiotics special rectification activity significantly contributes to the rationality of prophylactic medication in elective internal fixation of fracture in our hospital, but clinical pharmacists still need to normalize the management and continue to actively participate in antibiotics supervision to minimize irrational drug use.