我院围手术期预防应用抗菌药物调查分析  

SURVEY OF PERIOPERATIVE PROPHYLACTIC USE OF ANTIMICROBIAL AGENTS IN THE AFFILIATED HOSPITAL OF LUZHOU MEDICAL COLLEGE

作　　者：王述蓉[1] 余兆兰[2] 肖顺林[1] 王宁[3] 

机构地区：[1]泸州医学院附属医院药剂科,四川泸州646000 [2]泸州医学院附属医院肾病内科,四川泸州646000 [3]泸州医学院,2004级药学2班四川泸州646000

出　　处：《泸州医学院学报》2009年第4期402-404,共3页Journal of Luzhou Medical College

摘　　要：目的:分析我院围手术期抗菌药物使用基本情况,评价用药合理性。方法:对我院围手术期预防用药情况进行调研。随机抽取2008年1月1日至2008年2月28日手术病历共200份,对围手术期预防应用抗菌药物的合理性进行分析评价。结果:①围手术期预防性抗菌药物使用率为97.0%。②用药种类:按次序高低顺序前3位是广谱青霉素类,硝基咪唑类,喹诺酮类;广谱青霉素类占用药者的22.3%,硝基咪唑类、喹诺酮类分别为14.1%、12.4%,而一代头孢仅占15.0%;③每例平均用药天数:Ⅰ类切口为7.6d,Ⅱ类切口为9.0d,Ⅲ类切口为11.3d;④用药时机:手术开始前2h内用药者只占23.2%,手术结束后才用药占48.4%;⑤12.5%病例无用药适应症;⑥在抗菌药物的用法、用量、药物更换以及联合用药的指征掌握、药物配伍等方面,也存在诸多不合理现象。结论:我院围手术期抗菌药物使用率过高,疗程过长,在药物选择、用药时机、联合用药方面不合理、不规范的情况比较普遍,改进的空间较大。Objective： To investigate the prophylactic usage of antibiotics in perioperative period in our hospital, and evaluate the rationality of antibiotics usage. Methods： 200 medical records （from January to February, 2008） of our hospital were drawn out randomly. The perioperative prophylactic use of antimicrobial agents was investigated and analyzed. Results： Prophylactic antimicrobial agents were used in 194 cases （97.0%）. The first 3 antimicrobial agents most in use were Broad-spectrum Penicillins （22.3%）, nitroimidazole（14.1%）,and quinolones （12.4%）, the cephalosporins of 1st generation was only 15.0%. The average durations of antibiotic use were 7.6d for class I （clean） operations, 9.0 d for class II （clean/contaminated） operations and 11.3 d for class III （contaminated） operations. Only 23.2% of the patients received antibiotics within 2h before operation, and 48.4 % of the patients did not receive antibiotics until the operation was completed. Indications for prophylactic antibiotic use did not exist in 12.5% of cases. There were many unreasonable dosage, combinations and drug replacement in the use of antibacterial drugs. Conclusion： Inappropriate use of periopertive prophylactic antimicrobial agents is common and must be subjected to standardization.

关 键 词：围手术期 抗生素预防 合理化 

分 类 号：R181.35[医药卫生—流行病学]