围手术期预防使用抗菌药物合理性评价体系的建立与应用

目的 探索建立围手术期预防用抗菌药物合理性评价体系,为围手术期抗菌药物的合理应用及科学管理提供依据.方法 参考有关抗菌药物临床应用指南及文献,组织专家讨论建立合理性评价指标及标准,采用系统抽样法抽取276份围手术期预防用抗菌药物病历对建立的体系进行应用研究,不断完善合理性评价体系.结果 建立的抗菌药物合理性评价体系包括3个一级指标及13个二级指标；评价体系应用结果显示,某院围手术期预防用抗菌药物主要存在的不合理现象为药物选择、术前用药时机、术后给药时间、用药频次、药物单次剂量选择,不合理率分别为52.3％、71.7％、87.3％、63.5％、51.2％.结论 建立围手术期预防用抗菌药物合理性评价体系,可从抗菌药物临床应用的各个环节评价其合理性,评价结果能够反映抗菌药物临床应用的合理状况.

Establishment and application of evaluation system for rationality of prophylactic use of antibiotics during perioperative period

OBJECTIVE To establish a evaluation system for the rationality of prophylactic use of antibiotics during preoperative period so as to provide reference for the management of rational use of antibiotics.METHODS Referring to the related literatures and guidelines for clinical use of antibiotics,the experts discussed the evaluation indicators and criteria of establishing the evaluation system,the established system was tested by selecting 276 patients who took prophylactic antibiotics during perioperative period with systematic sampling method so as to constantly improve the evaluation system for the rationality.RESULTS The established evaluation system included two levels,in which there were 3 first grade indicators and 14 second grade indicators.The study on the application of the evaluation system showed that the irrational conditions mainly included the irrational drug choice(52.3%),the improper medication timing(71.7%) before operation,the medication after operation(87.3%),irrational medication frequency(63.5%) and the overdose(51.2%).CONCLUSION The established evaluation system can evaluate the key links about prophylactic use of antibiotics during preoperative period,the results of evaluation can reflect the conditions of the clinical prophylactic use of antibiotics.