我院Ⅰ类切口手术围术期预防用抗菌药物合理性评价

目的:评价我院Ⅰ类切口手术围术期预防用抗菌药物的合理性。方法:选取我院2010年7-12月Ⅰ类切口手术患者的归档病历171份,制定围术期合理应用抗菌药物评价标准,对抗菌药物的药品选择、给药时间、用法用量、用药疗程、更换药物等项目进行系统评价。结果:我院抗菌药物应用率占78.9%(135/171),其中合理者57例(42.2%),不合理者78例(57.8%)。不合理用药主要包括疗程过长26例(33.3%)、药品选择不当25例(32.1%);预防用抗菌药物主要以第1、2代头孢菌素为主,选用头孢唑林60例(44.4%)、头孢硫脒35例(25.9%)。结论:我院Ⅰ类切口围术期预防用药率较高,存在用药指征把握不严、抗菌药物选择不当、使用时间较长等问题,有待进一步规范。

Reasonability Evaluation for Perioperative Prophylactic of Application of Antibiotics in Type I Incision in Our Hospital

OBJECTIVE ： To evaluate the rationality of perioperative prophylactic application of antibiotics in type I incision in our hospital. METHODS： 171 medical records of patients with type I incision operation were collected from our hospital during JulDec. in 2010. Evaluation criteria for rational use of antibiotics during perioperative period was developed to evaluate systematical- ly drug selection, medication time, dosage and usage, medication duration, drug change, etc. RESULTS： The use of antibiotics in our hospital accounted for 78.9% （135/171）, in which the reasonable were 57 cases （42.2 % ）, the unreasonable were 78 cases （57.8%）. The main unreasonable use included： treatment course of 26 cases was too long（33.3% ）, drug selection of 25 cases were inappropriate （32.1% ）. Antibiotics for prophylactic application were mainly first and second generation cephalosporin. 60 cases adopted cefazolin （44.4%）, and 35 cefathiamidine （25.9%）. CONCLUSION： The ratio of perioperative prophylactic application of antibiotics is high in our hospital. Some problems should be further standardized, such as not confirming medication indicator, irrational selection of antibiotics and prolonged application.