医院眼科清洁切口手术预防使用抗菌药物管理效果分析  

Effect of administration of prophylactic antibiotics for clean incision surgery of ophthalmology department

作　　者：袁晓宁[1] 赵心懋[1] 王少利[1] 林晨曦[1] 杨雪松[1] 

机构地区：[1]北京大学第三医院医院感染管理科,北京100191

出　　处：《中华医院感染学杂志》2013年第20期5037-5039,共3页Chinese Journal of Nosocomiology

基　　金：首都医学发展科研基金(2009-3029)

摘　　要：目的为规范眼科清洁切口手术预防使用抗菌药物,探索有效的干预措施,促进临床合理应用抗菌药物。方法对2011年1月-2013年3月医院眼科住院患者接受清洁切口手术进行目标监测,多部门、多专业联合进行抗菌药物合理应用知识培训、抗菌药物使用在线监测、实时反馈、临床药师科室指导、医院感染实时监测等综合干预,评价干预效果。结果 2011年1月-2013年3月共10 260例患者进行眼科清洁切口手术,抗菌药物使用率由2011年的57.13%下降至2012年的42.12%,2013年第一季度达到6.33%;使用时机正确率由2011年的86.91%上升至2012年的90.43%,2013年第一季度达到96.00%;术后24h停药率由2011年的59.30%上至2012年的81.50%,2013年第一季度达到89.33%;在降低眼科清洁切口手术抗菌药物使用率的同时,手术部位感染率、医院感染发病率差异无统计学意义。结论多科室联合的综合干预措施安全、有效,为医院加强其他科室清洁切口手术预防使用抗菌药物管理提供了循证依据。OBJECTIVE To regulate the use of prophylactic antibiotics for clean incision surgery of ophthalmology department and explore effective intervention measures so as to promote the reasonable clinical medication. METHODS A targeted surveillance was performed for the hospitalized patients who received the clean incision surgery from Jan 2011 to Mar 2013, then the comprehensive interventions were carried out by the multisectoral and multi-disciplinary collaboration, including the training of knowledge of reasonable medication, online surveillance of use of antibiotics, real-time feedback, clinical pharmacist＇s guidance, and reaPtime surveillance of nosocomial infections, and the effectiveness of the interventions was evaluated. RESULTS Of totally 10 260 cases of patients who underwent the ophthalmic clean incision surgery from Jan 2011 to Mar 2013, the utilization rate of antibiotics decreased from 57.13% in 2011 to 42.12~ in 2012, reaching up to 6.33% in the first quarter of 2013; the rate of reasonable timing increased from 86.91% in 2011 to 90.43% in 2012, reaching up to 96.00% in the first quarter of 20133 the rate of drug withdrawal 24 hours after surgery increased from 59. 30% in 2011 to 81.50% in 2012, reaching up to 89.33% in the first quarter of 2013. As the utilization rate of antibiotics was reduced, the difference in the change of incidence of the surgical site infections or the nosocomial infections was not significant. CONCLUSION The comprehensive interventions under the multisectoral collaboration are safe and effective, which provide evidence-based basis for the administration of prophylactic antibiotics for the clean incision surgery in other departments.

关 键 词：清洁切口 抗菌药物 预防使用 干预 

分 类 号：R978.1[医药卫生—药品]