三级综合医院围手术期抗生素使用现状及对策研究

目的:分析医院围手术期预防性使用抗菌药物现状,提高合理用药水平。方法:选择2005年7月-2007年6月Ⅰ、Ⅱ类切口手术6 579例为强化前组,2007年7月-2008年6月强化规范抗生素使用后,Ⅰ、Ⅱ类切口手术4 521例为强化后组,分析两组围手术期预防性应用抗菌药物情况、手术切口感染及住院费用、抗菌药物费等。结果:手术部位感染发生率强化后组与强化前组比较无显著差异,强化后组在抗菌药物使用的规范性、使用费用及住院费用等与强化前组相比有显著性差异(P<0.01)。结论:《抗菌药物临床应用指导原则》颁布实施后,围手术期抗菌药物预防性应用的不合理情况仍普遍存在,通过强化规范后,趋于合理,但同国外发达国家相比,仍有一定差距。

Perioperative Prophylactic Application of Antibiotics in Tertiary General Hospital and Countermeasures

Objective：To evaluate the perioperative prophylactic application of antibiotics so as to provide a further guidance for rational drug use.Methods：Choose patients of type Ⅰ、Ⅱsurgical incision from July 2005 to June 2007（6 579 cases）for a group,from July 2007 to June 2008（4 521 cases）for enhanced group,analyzed status of the prophylactic application of antibiotics,hospitalization costs,antimicrobial drug costs,etc.Results：The surgical site infection rate of two groups had no significant difference,and there was significant difference in the standardization of antimicrobial drug use,hospitalization costs,antimicrobial drug costs of them（P0.01）.Conclusion：Unreasonable situation of preoperative prophylactic application of antibiotics is still widespread.Through aggrandizement supervisory management,situation takes a favorable turn apparently,but compared with the developed countries,there still has a certain gap.