干预前后威海卫人民医院普外科围手术期预防用抗菌药物的比较

目的分析威海卫人民医院干预前后普外科围手术期预防用抗菌药物的使用情况,为合理使用抗菌药物提供依据。方法选取威海卫人民医院普外科2015年3~5月(干预前)与2016年3~5月(干预后)的围手术期病例各122例,比较干预前后抗菌药物的用药指征、用药疗程、药物选择、用法用量、无指征换药和用药途径。结果干预后,用药指征不合理例数明显低于干预前,且无指征用药多存在于Ⅱ类切口手术;干预后抗菌药物应用时间多为24 h之内,明显短于干预前,干预前后比较差异具有统计学意义(P0.05);干预前用药头孢菌素类占49%,喹诺酮类占29%,干预后头孢菌素类占79%,克林霉素类占13%,干预后药物选择合理性较干预前明显改善;干预前有2例无指征换药和2例用药途径不合理情况,干预后无此类不合理情况;干预后患者的住院时间缩短,感染率降低,费用明显减少(P0.01)。结论积极的干预普外科围术期抗菌药物预防用药,可改善其不合理用药情况,降低患者术后感染的发病率、减少住院时间和费用。

Comparison on perioperative prophylactic application of antibiotics in Department of General Surgery of Weihaiwei People's Hospital before and after intervention

Objective To analyze the prophylactic use of antibiotics in perioperative prophylactic application of antibiotics in Department of General Surgery of Weihaiwei People's Hospital before and after intervention, and to provide valuable reference for rational use of antibiotics.Methods Perioperative patients (122 cases) in Department of General Surgery of Weihaiwei People's Hospital from March to May 2015 (before intervention) and March to May 2016 (after intervention) were respectively selected, medical indication, medicinal course, drug choice, usage and dosage, no indications of dressing change, and route of administration were compared before and after intervention.Results After intervention, the irrational cases in medical indication were less than those before intervention, and most of them happened to Ⅱ class incision. After intervention, the application time of most antibiotics was less than 24 h, which was less than that before intervention, and there was significant difference between those before and after intervention (P<0.05). Before intervention, cephalosporins accounted for 49%, and quinolones accounted for 29%, while after intervention, cephalosporins accounted for 79%, and clindamycins accounted for 13%. The rationality of drug choice was improved after intervention. There were 2 cases of patients with no indications of dressing change and 2 cases of patients with unreasonable route of administration before intervention, while there was no unreasonable medication after intervention. There was a dramatically downward trend in patient's treating duration, infection rate, and treatment costs after intervention (P<0.01). Conclusion Active intervention in perioperative prophylactic application of antibiotics in Department of General Surgery can improve the irrational medication, decrease the incidence of postoperative infection, and reduce hospitalization time and cost.