我院围术期抗菌药物应用干预比较研究

目的：探讨用药干预对围术期抗菌药物应用合理性的影响。方法：将我院2009年7月-2011年6月470例患者分为干预组与非干预组,并分别按切口类型分为Ⅰ、Ⅱ、Ⅲ、Ⅳ类切口4个亚组,对同类切口亚组的同病种患者进行对照;分别对其抗菌药物应用品种、用药合理性、用药费用等进行比较。结果：干预组患者抗菌药物应用档次及联用比例、更换次数均明显低于非干预组（P〈0.05）;干预组与非干预组未用药、应用青霉素类的比例分别为4.80%、14.40%和1.74%、3.77%。干预组合理应用比例显著高于非干预组（P〈0.05）,2组不合理用药例次分别为51、362例次。干预组总费用、总药品费用和抗菌药物费用均显著低于非干预组（P〈0.05）,且干预组中4种不同切口亚组之间抗菌药物费用比较差异有统计学意义（P〈0.05）,而非干预组亚组间比较差异无统计学意义（P〉0.05）。结论：用药干预能减少围术期抗菌药物应用,提高抗菌药物应用合理性,降低费用。

Comparative Study of Antibiotic Use Intervention in Our Hospital during Perioperative Period

OBJECTIVE： To discuss the influence of medication intervention on rational use of antibiotic during perioperative period. METHODS： 470 cases of our hospital from Jul. 2009 to Jun. 2011 were divided into intervention group and non-intervention group. And according to different incision types, both two groups were further divided into four sub-groups, namely, typeⅠ,Ⅱ,Ⅲ and Ⅳ incision sub-groups. The cases of the same kinds of diseases in the correspondent sub-groups were compared. The kinds of antibiotic, reasonability and expense of medication were compared. RESULTS： The level, the frequency of combined use and shift of antibiotics in intervention group were apparently lower than non-intervetion group （P0.05）. Application rates of no antibiotics and penicillins in intervention group were 4.80% and 14.40%, while in non-intervention group were 1.74% and 3.77%. The proportion of reasonable antibiotic use in intervention group was higher than in non-intervetion group（P0.05）. The case times of unreasonable antibiotic use in 2 groups was respectively 51 cases and 362 cases. The total treatment costs, total drug cost and antibiotic cost of intervention group were lower than those of non-intervention group significantly（P0.05）. There was significant difference in antibiotic cost among 4 incision sub-groups （P0.05） in intervention group, while in non-intervention group no similar difference could be found（P0.05）. CONCLUSION： Medication intervention is worthwhile to be popularized, for it can reduce the use of antibiotics, improve reasonable use of antibiotic, cut down treatment costs and promote pharmacoeconomic benefits.