围手术期预防使用抗菌药物指南的依从性研究  

Compliance with guidelines of prophylactic application of antibiotics in perioperative period

作　　者：史天陆[1] 邓明影[1] 苏丹[1] 孙言才[1] 姜玲[1] 

机构地区：[1]安徽医科大学附属省立医院药剂科,安徽合肥230001

出　　处：《中华医院感染学杂志》2014年第11期2662-2664,共3页Chinese Journal of Nosocomiology

基　　金：安徽省软科学研究基金资助项目(12020503083)

摘　　要：目的探讨围手术期预防使用抗菌药物的指南依从性,为开展抗菌药物临床应用专项整治活动提供依据。方法采用回顾性调查方法,随机抽取医院2011年1-3月200份手术患者出院病历,结合专项整治有关围手术期预防用药指标控制要求,选取适应证、药物选择、用药时机、用药疗程等关键指标,参照《围手术期预防应用抗菌药物指南》对所选病例的围手术期预防用药进行指南依从性研究。结果 200例手术患者围手术期抗菌药物预防使用率达91.0%,其中123例Ⅰ类切口手术患者中有105例使用抗菌药物,使用率为85.4%;使用频次位居前3位的抗菌药物品种依次是头孢硫脒72例次、头孢西丁51例次、呋布西林39例次,使用率分别为36.0%、25.5%和19.5%;给药时机、用药指征和联合用药方面指南依从性较好,依从率依次为92.9%、91.2%和91.2%;在用药疗程、药物选择和用法用量等方面指南依从性较差,依从率依次为6.6%、42.3%和66.5%。结论围手术期预防用抗菌药物的指南依从性研究结果,为医院深入开展抗菌药物临床应用专项整治活动提供了针对性强的切入点和工作依据。OBJECTIVE To explore the compliance with guidelines of prophylactic antibiotics using in perioperative period, so as to provide references to the special rectification activities of clinical application of antibiotics. METHODS A total of 200 medical records from inpatients from Jan. to Mar. in 2011 were randomly selected and retrospective analyzed. Considering about the request from the special rectification activities of clinical application of antibiotics, indications, drug choice, drug timing, medication duration and other key indicators were selected and according to the guideline of prophylactic application of antibiotics in perioperative period, the study of compliance with guidelines was taken. RESULTS The rate of prophylactic antibiotics using in perioperative period was 91.0% in total of 200 cases, among which 105 cases in 123 cases of patients with types I incision surgery used antibiotics, accounting for 85.4%. The first three places on the list of DDDs were cefathiamidine 72 cases, cefoxitin 51 cases and furbenicillin sodium 39 cases, accounting for 36. 0%, 25. 5% and 19. 5%. Timing of administration, drug indications and combination therapy guided were performed better, and the average compliance rates were 92.9%, 91.2% and 91.2% respectively. The compliance of medication duration, choice of drug kinds, usage and dosage were poor, and the average compliance rates were 6. 6%, 42. 3% and 66. 5% respectively. CONCLUSIONS The compliance results of compliance with guidelines of prophylactic antibiotics using in perioperative period will provide important basis and good targeted entry point to carry out the special rectification activities of clinical application of antibiotics for hospitals.

关 键 词：专项整治 围手术期 抗菌药物 预防用药 依从性 

分 类 号：R978.1[医药卫生—药品]