某院3种清洁手术围术期抗菌药物干预情况分析  

Analysis on the effect of intervention of perioperative of antibiotics in 3 kinds of clean operation

作　　者：唐秀能[1] 陈英[2] 韦红棉[1] 梁秀群[1] 唐云峡[1] 

机构地区：[1]广西中医药大学附属瑞康医院药剂科,南宁530011 [2]广西壮族自治区人民医院药学部,南宁530021

出　　处：《重庆医学》2013年第17期1994-1996,共3页Chongqing medicine

基　　金：广西科学研究与技术开发计划基金资助项目(桂科攻0993003B-29)

摘　　要：目的分析该院3种清洁手术围术期预防用抗菌药物的干预效果,为医疗机构促进围术期抗菌药物的合理使用提供参考模式。方法对该院2009年10月乳腺、甲状腺、疝气等3种清洁切口手术患者的用药情况做基线调查,分别于2010年4月、2010年10月和2011年7月对这3种清洁切口手术进行抗菌药物预防用药干预,并对干预效果进行分析。结果与基线调查组相比,干预后第3阶段合理率由5.0%提高到37.5%,无指征用药、选择药物不合理、用药途径不合理、术后用药时间过长等方面的比例都得到显著下降,抗菌药物平均费用及平均用药时间都得到显著改善,每例患者平均不合理项目由基线调查组的2.47下降到第3阶段组的1.01。但干预后的指标还没有达到《抗菌药物临床应用指导原则》的要求。结论合理用药培训、临床药师参与临床用药和行政干预相结合的干预手段是一种有效、可行的合理用药干预模式,可进一步推广使用,以利于抗菌药物合理应用的持续改进。Objective To analyse the intervention effect on perioperative prophylactic application of antibiotics in 3Kinds of clean operation in our hospital,and provide a reference model for the perioperative rational application of antibiotics in medical institutions.Methods The drug use for patients with mastectomy,thyroidectomy or hernia in 3kinds of clean incision operation in Oct.2009were investigated as the baseline,then the drug use for patients with those 3kinds of clean incision operation in Apr.2010,Oct.2010and Jul.2011were intervened and analyzed in our hospital respectively.Results The rate of rational use of antibiotics were increased from 5.0%in baseline stage to 37.5%after intervention in the third stage.Compared with the baseline,the ratio of the treatment with no indications,inappropriate drug selection,unreasonable route of administration,long course of treatment were decreased remarkable,and,at the same time,average cost of antibiotics and duration of medication were improved significantly after intervention,the average unreasonable items were decreased from 2.47in baseline stage to 1.01after intervention of the third stage.However,the target of after intervention have not met＂the guiding principle of antibiotics in clinical application＂.Conclusion Rational use of drug training,clinical pharmacists participating in clinical medication and administrative intervention are feasible and effective intervention model,and can be further popularized.

关 键 词：手术期间 抗菌药 干预性研究 合理用药 

分 类 号：R619[医药卫生—外科学]