某院清洁手术围手术期预防性应用抗菌药物干预前后对比分析

目的：调查干预前后该院清洁手术围手术期预防性应用抗菌药物的情况,为临床合理用药提供参考。方法随机抽取该院2011年1-6月Ⅰ类切口手术出院病历36份（干预前组）,2012年1-6月Ⅰ类切口手术出院病历46份（第一阶段干预后组）,2013年1-6月Ⅰ类切口手术出院病历33份（第二阶段干预后组）,对比分析持续干预前后抗菌药物预防应用情况。结果经积极持续干预,与2011年相比,该院清洁手术围手术期抗菌药物使用率由97.2%下降到18.2%、术后24 h内抗菌药物使用率由40.0%上升到83.3%,人均抗菌药物总费用占药品总费用的比也由13.66%降为2.66%。结论经过2个阶段的积极干预措施是可行的、有效的,该院清洁手术围手术期抗菌药物使用情况得到明显改善。

Comparative study of the application of prophylactic antibacterial agents on clean surgery between before and after the antibacterial intervention

Objective To analyze the clinical effect of the two-stage intervention approach of prophylactic antibacterial drugs using during perioperative period of the clean surgery,and to provide references for proper use of antibacterial drugs in clinic. Methods Da-ta of the antibacterial drugs usage were collected from the individual three different groups： one group of pre-intervention data was gained from 36 cases of type I incision operations conducted between January and June,2011. The other two groups of post-intervention data were gained from the 46 cases of type I incision operations （ first phase） from January to June,2012 and from the 33 cases of type I incision operations （second phase） between January and June,2013. Results Compared with pre-intervention in 2011,the percent-age of prophylactic use of antibiotics decreased from 97. 2% to 18. 2% after intervention. The usage rate of antibiotics in the 24 hour post-operation rose from 40. 0% to 83. 3%. The ratio of the per capita total cost of antibacterials to the total cost of hospital drugs de-creased from 13. 66% to 2. 66%. Conclusions The two-stage active intervention was proved to be practicable and effective in impro-ving the efficacy of prophylactic administration of antibacterial drugs for clean surgery.