16家医院围手术期预防性应用抗菌药物的调查与分析

目的了解自贡地区各级医疗机构围手术期预防性应用抗菌药物的情况。方法回顾性随机抽查16家不同等级医院Ⅰ类切口手术病历460份,填写《外科围手术期预防性应用抗菌药物调查表》,对预防用药的适应证、用药种类、联合用药、给药时机及持续时间进行统计分析。结果 460例患者均预防性使用了抗菌药物,药物总品规数为568种,人均使用1.23种;预防用药时机及持续时间不符合规定198例次(43.04%),药物选择不当150例次(32.61%),联合用药无指征112例次(24.35%);经综合判断,用药不合理(欠妥)222例(48.26%)。结论不同级别的医院对Ⅰ类切口手术患者围手术期药物选择、给药时机与持续时间、联合用药等的合理性差异显著,因此需提高对合理使用抗菌药物的认识,加强管理。

Investigation and Analysis on Perioperative Prophylactic Use of Antimicrobials in 16 Hospitals

Objective To understand the status of perioperative prophylactic use of antimicrobials in the medical institutions at various levels in Zigong area for evaluating its rationality.Methods The medical records of 460 cases of type Ⅰincision surgery were randomly checked in 16 hospitals at different levels and the investigation questionnaires were filled for statistical analysis on indications,drug categories,drug combination,medication timing and duration in perioperative prophylactic use of antimicrobial drugs.Results Among 460 medical records,460 cases used prophylactic antimicrobial drugs,with total 568 varieties of drugs and per capita use of 1.23 varieties.Preventive medication time and duration were not in conformity with the provisions in 198 case-times（43.04%）,improper selection in 150 case-times（32.61%）,no indication of drug combination in 112 case-times（24.35%） and irrational or less rational in 222 case-times（48.26%）.Conclusion The rationality of perioperative drug selection,medication timing,using duration and combination use in type Ⅰincision operations has significant difference among hospitals at different levels.Cognition on rational antimicrobials use should be increased and the management should be strengthened.