1800例围手术期抗菌药物预防应用调查分析

目的分析及了解本院5年来围手术期预防使用抗菌药物情况。方法2008—01—2012—12每月随机抽取一个手术科室病历30份，5年间共抽取手术病历1800份。分别从用药时机、品种选择、用法用量、术中追加、用药时间和联合用药等6方面，对围手术期预防用药进行合理性评价、分析，并对历年抗菌药物的使用情况进行比较。结果1800份病例中使用抗菌药物1462例，抗菌药物选择合理占81．22％，给药时机合理67．03％，用法用量合理为95．28％，用药时间合理为75．03％，术中追加药物合理为59．33％，联合使用抗菌药物合理性占52．88％。结论本院围手术期预防用药各项指标合理的比例总体较高。从5年的横断面来比较，各项指标不合理比例呈下降趋势。可见近几年本院对临床抗菌药物应用监控及综合治理取得了一定的成效。

Research and Analysis of 1 800 Cases of PerioperativePreventive Application of Antimicrobial Drugs

To analyze and investigate the perioperative preventive application of antibacterial drugs in 5 years of the hospital. Methods 30 medical records of a operation department were randomly selected every month, a total of 1 800 copies of surgical medical records were collected from 2008-01 to 2012-12. Reasonable evaluation and analysis of the perioperative prophylaxis were established on the following aspects： medication timing, drug selection, drug application and dosage, additional application in the intraoperative period, and combination application. The application situation of antibacterial drugs throughout 5 years was compared. Results Of the total 1 800 cases, 1 462 cases had applied antibacterial drugs. Cases that had selected the rational antimicrobial drugs accounted for 81. 22%, and reasonable delivery time accounted for 67.03%, reasonable drug application and dosage accounted for 95.28%, the reasonable medication timing accounted for 75.03 %, and additional drugs in intraoperative period accounted for 59.33%, the rational combination application of antimicrobial drugs accounted for 52. 88%. Conclusion The proportion of reasonable perioperative preventive application of antibacterial drugs is generally higher in each index of the hospital. In the cross section comparison for 5 years, the proportion of unreasonable application in each index has declined. The monitoring and comprehensive management of antibacterial drugs clinical application in the hospital has achieved certain success in recent 5 years.