临床药师干预对骨科围术期抗菌药物使用的影响

目的探讨临床药师干预对骨科围术期抗菌药物使用的影响。方法采用回顾性调查的方法,随机抽取我院临床药师干预前(2010年6-7月)和干预后(2010年11-12月)的各60例骨科Ⅰ类切口手术病例,对其围术期使用的抗菌药物的种类、DDDs、联合用药、用药时间、费用等进行统计分析。结果干预前后抗菌药物的使用率均为100%,涉及5类10种药物,其中单一用药分别为10例(16.67%)、58例(96.67%),二联用药分别为47例(78.33%)、2例(3.33%),三联用药为3例(5%)、0例(0%);术前用药时间>2h的分别为43例(71.67%)、16例(26.67%);术后用药时间超过48 h的分别为48例(60%)、6例(10%);人均住院总费用分别为20 100.97元、13 038.52元;人均抗菌药物费用分别为2660.25元、566.09元;抗菌药物合理应用率分别为16.67%、85%。经统计两组骨科手术病例围术期用药,在合理性、住院及药品费用方面差异有统计学意义。结论临床药师干预可促进骨科围术期抗菌药物合理使用,为临床安全、有效、经济使用抗菌药物提供参考。

Effect of intervention of clinical pharmacists on antibacterial drug uses in or-thopaedic peri-operation period

AIM To observe the effect of the intervention of clinical pharmacists on uses of antibacterial drug in orthopaedic peri-operative period. METHODS The research was made within 60 cases of the use of antibacterial drugs in orthopaedic I class incision operation through peri-opemtive period in Hangzhou First people＇s Hospital before inter- vention （during June-July 2010） and after intervention （during November-December 2010）, including the kinds of an- tibacterial drugs, DDDs, combined medication, medication time and expenses of antibacterial drugs. RESULTS The findings showed that the antibacterial drug usage was 100% before intervention and after intervention involving 10 kinds of drugs of 5 categories. Among them single administration was respectively 10 cases （16.67%） and 58 cases （96.67 % ）. Two combined administration was respectively 47 cases （78.33 % ） and 2 cases （3.33 % ）. Three combined administration was respectively 3 cases （5%） and 0 cases （0%）. Preoperative medication time for more than 2 h was re- spectively 43 cases （71.67%） and 16 cases （26.67%）. Postoperative medication time for more than 48 h was respec- tively 48 cases（60% ） and 6 cases（ 10% ）. The total hospital costs for per person were respectively 20 100.97 yuan and 13 038.52 yuan. The per antibacterial drug costs were respectively 2 660.25 yuan and 566.09 yuan. The ratio of ratio- nal utilization of drugs was respectively 16.67% and 85%. Judging from the above data, we found that there was a sig- nificant difference between the 2 groups in rationality and the total hospital costs of drug usage. CONCLUSION It is concluded that the intervention of clinical pharmacists in orthopaedic peri-operation period is reasonable as well as neces- sary to achieve the best therapeutic effectiveness.