干预前后驻马店市中心医院Ⅰ类切口预防用抗菌药物的使用情况比较

目的对驻马店市中心医院Ⅰ类切口预防用抗菌药物的使用情况进行统计分析,为临床合理应用抗菌药物提供参考。方法随机抽取2016年(干预前)和2017年(干预后)驻马店市中心医院的Ⅰ类切口手术病例,比较干预前后Ⅰ类切口手术预防用抗菌药物的使用率、给药时机和品种选择合理率、原则上不预防用抗菌药物的手术类型及病例数、抗菌药物不合理应用病例数量等。结果干预前后Ⅰ类切口手术预防用抗菌药物的使用率分别为27.03%、19.05%,给药时机、品种选择、预防用药疗程合理率分别由85.73%、78.60%、76.62%提高至95.04%、94.49%、84.56%;预防用药平均天数由4.95 d降至3.11 d;原则上不使用抗菌药物预防手术的抗菌药物使用率由6.41%降至2.38%。干预前后Ⅰ类切口手术预防用抗菌药物均以第1、2代头孢类抗菌药物为主,干预后使用率明显提高。干预后给药时机、品种选择、疗程不合理率较干预前显著降低(P0.05),用法用量不合理、不当联合预防用药等不合理用药比例降幅明显。结论通过综合干预,Ⅰ类切口手术预防用抗菌药物的使用日趋规范,干预效果明显。

Comparison on use of prophylactic application of antibiotics in type I incision in Zhumadian Central Hospital before and after intervention

Objective To understand the prophylactic application of antibiotics in type I incision in Zhumadian Central Hospital, and to provide reference for clinical rational use of antibiotics. Methods Patients with type I incision in Zhumadian Central Hospital from 2016 (before intervention) and 2017 (after intervention) were respectively selected, and usage rate, reasonable utilization rate of administration time and drug choice, surgery type not prevent the use of antibacterials in principle, and cases of unreasonable use were compared before and after intervention. Results The utilization ratio of prophylactic application of antibiotics before and after intervention were 27.03% and 19.05%, respectively. The reasonable rate of administration time, drug choice, and prophylactic treatment course increased from 85.73%, 78.60%, and 76.62% to 95.04%, 94.49%, and 84.56%, respectively. The average days of prophylactic use of drugs decreased from 4.95 d to 3.11 d. The antimicrobial medicine usage ratio of surgeries types which will not use the antimicrobial medicines in principle has been down apparently from 6.41% to 2.38%. The first and second generation cephalosporins were mainly used in type I incision before and after intervention, and the use rate was significantly increased. The unreasonable use rate of administration time, drug choice, and course of treatment were significantly decreased, and there was difference before and after the intervention (P<0.05). Conclusion By comprehensive intervention, the prophylactic application of antibiotics in type I incision is rational gradually, proving that the comprehensive intervention is obviously effective.