围分娩期预防性使用抗菌药物临床分析

目的 通过对本院产科围分娩期抗菌药物使用病历进行回顾性统计分析,掌握围分娩期预防性使用抗菌药物的情况.方法 回顾性分析产科1223例住院患者中710例围分娩期使用抗菌药物的患者,观察分析围分娩期患者抗菌药物使用指征及构成比、抗菌药物品种选择及给药剂量、胎膜早破以及人工破膜患者胎膜破裂距离分娩时间.结果 1223例住院患...

Clinical analysis of prophylactic use of antibiotics in perinatal period

Objective To master the situation of the prophylactic use of antibiotics during the perinatal period through the retrospective statistical analysis of the medical records of the use of antibiotics in the obstetric department of our hospital during the perinatal period.Methods The clinical data of 710 cases of 1223 obstetric inpatients who used antibiotics during perinatal period were analyzed retrospectively.The indications and constituent ratio of antibiotics used in perinatal patients,the selection and dosage of antibiotics,the distance between rupture of membranes and delivery time in patients with premature rupture of membranes and artificial rupture of membranes.Results 710 cases of 1223 hospitalized patients used antibiotics during perinatal period,and the utilization rate of antibiotics was 58.1%.Among them,402 cases(56.6%)were normal delivery,308 cases(43.4%)were cesarean section.Among the normal delivery patients,there were 201 patients(28.3%)with premature rupture of membranes(PROM)without group B streptococcus(GBS)positive,108 patients(15.2%)with GBS positive,and 68 patients(9.6%)without GBS-positive artificial rupture of membranes to induce labor,the other were 25 cases(3.5%).Among 710 patients in the perinatal period,cefuroxime sodium was the most used antibacterial drug with 550 cases(77.5%),followed by cefazolin sodium with 62 cases(8.7%),and penicillin sodium was the third with 47 cases(6.6%),of which 31 cases(4.4%)were combined with antibiotics.The combination regimen was mainly cefuroxime sodium or ceftriaxone sodium combined with metronidazole for anti-infective treatment in 26 cases,accounting for 83.9%.Except cefuroxime axetil tablets,clindamycin palmitate dispersible tablets,cefdinir dispersible tablets and moxifloxacin tablets,the route of administration was oral administration,and other drugs were intravenous drip.Patients with GBS-positive labor or fetal membrane rupture should promptly initiate infection prevention treatment;those who have not undergone GBS screening at 34-36+6 weeks of gestation and near term PROM are admitted to the hospital to start infection prevention treatment in time;patients with term premature rupture of membranes and patients with artificial rupture of membranes to induce labor start antibiotics to prevent infection within 6 h after membrane rupture;patients with cesarean section received prophylactic use of antibiotics after umbilical cord broken.Conclusion Prophylactic use of antibiotics during the perinatal period in our department is basically reasonable,but there are also shortcomings,mainly in the timing of the use of antibiotics is different from the guidelines.