Ⅰ类切口手术预防性抗菌药物应用情况分析
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摘要
目的探讨分析该院Ⅰ类切口手术预防性抗菌药物应用情况,为临床用药提供参考和指导。方法分别于20166—12月(开展药学服务前)、2017年1—6月(开展药学服务后)各抽选66例Ⅰ类切口手术患者,设为对照组和观察组,回顾性分析两组抗菌药物临床应用情况。结果 2016年6—12月对照组66例患者中50例给予抗菌药物预防性抗感染,占比75.8%;开展药学服务后,2017年1—6月观察组66例患者中13例给予抗菌药物预防性抗感染,占比19.7%,观察组抗菌药物预防性应用率明显低于对照组,差异有统计学意义(χ~2=41.571,P=0.000);与对照组相比,观察组Ⅰ代头孢菌素应用率明显提升,青霉素及β-内酰胺类、Ⅱ代头孢菌素及Ⅲ代头孢菌素应用率明显下降(观察组Ⅰ代头孢菌素12/13=92.3%,对照组Ⅰ代头孢菌素7/50=14.0%),差异有统计学意义(χ~2=30.037,P=0.000);观察组抗菌药物应用不合理情况明显优于对照组(用药时间过长、抗菌药物选择不合理、联合用药、无用药指征、起始给予时间不合理,差异有统计学意义(χ~2=4.690,4.846,4.259,5.868,5.576,P=0.025,0.025,0.034,0.013,0.013)。结论该院Ⅰ类切口手术抗菌药物存在用药不合理现象,实施合理有效的药学干预后,有效降低了抗菌药物预防性应用率及不合理用药发生率,确保了抗菌药物应用结构的合理性。
Objective To analyze the application of preventive antibiotics in class Ⅰ incision surgery in the hospital, and to provide refer-ence and guidance for clinical drug use. Methods Sixty-six patients with type Ⅰ incision surgery were selected in the second half of 2016 June to December and the first half of 2017 January(after the pharmacy service). The patients in the control group and the ob-servation group were retrospectively analyzed. Results 2016 June to December, 50 of the 66 patients in the control group were given antibiotics, accounting for 75.8%. After the pharmacy service, 13 of the 66 patients in the observation group 2017 January to June were given antibiotics infection, accounting for 19.7%, the prophylactic application rate of antibacterial drugs in the observation group was significantly lower than that of the control group, the difference was significant,the different was statistically significant( χ~2=41.571, P =0.000); compared with the control group, the application rate of the first generation cephalosporin was significantly im-proved in the observation group. The application rate of penicillin and β-lactam, Ⅱ cephalosporin and Ⅲ cephalosporin decreased significantly(observed group Ⅰ cephalosporin 12/13=92.3%, control group Ⅰ cephalosporin 7/50=14.0%),the different was statistically significant(χ~2=30.037, P=0.000); the unreasonable application of the antibacterial drugs in the observation group was significantly bet-ter than the control group(the drug administration time was too long, the antibacterial drug selection was unreasonable, the combina-tion drug, the drugless indication, the initial administration time was unreasonable,the different was statistically significant(χ~2= 4.690,4.846, 4.259, 5.868, 5.576, P=0.025, 0.025, 0.034, 0.013, 0.013). Conclusion The antibiotics in Class Ⅰ incision surgery in the hospital have unreasonable drug use. After reasonable and effective pharmacy intervention, the preventive application rate of antibiotics and the incidence of irrational drug use are effectively reduced, which ensures the rationality of the application structure of antibacterial drugs.
Objective To analyze the application of preventive antibiotics in class Ⅰ incision surgery in the hospital, and to provide refer-ence and guidance for clinical drug use. Methods Sixty-six patients with type Ⅰ incision surgery were selected in the second half of 2016 June to December and the first half of 2017 January(after the pharmacy service). The patients in the control group and the ob-servation group were retrospectively analyzed. Results 2016 June to December, 50 of the 66 patients in the control group were given antibiotics, accounting for 75.8%. After the pharmacy service, 13 of the 66 patients in the observation group 2017 January to June were given antibiotics infection, accounting for 19.7%, the prophylactic application rate of antibacterial drugs in the observation group was significantly lower than that of the control group, the difference was significant,the different was statistically significant( χ~2=41.571, P =0.000); compared with the control group, the application rate of the first generation cephalosporin was significantly im-proved in the observation group. The application rate of penicillin and β-lactam, Ⅱ cephalosporin and Ⅲ cephalosporin decreased significantly(observed group Ⅰ cephalosporin 12/13=92.3%, control group Ⅰ cephalosporin 7/50=14.0%),the different was statistically significant(χ~2=30.037, P=0.000); the unreasonable application of the antibacterial drugs in the observation group was significantly bet-ter than the control group(the drug administration time was too long, the antibacterial drug selection was unreasonable, the combina-tion drug, the drugless indication, the initial administration time was unreasonable,the different was statistically significant(χ~2= 4.690,4.846, 4.259, 5.868, 5.576, P=0.025, 0.025, 0.034, 0.013, 0.013). Conclusion The antibiotics in Class Ⅰ incision surgery in the hospital have unreasonable drug use. After reasonable and effective pharmacy intervention, the preventive application rate of antibiotics and the incidence of irrational drug use are effectively reduced, which ensures the rationality of the application structure of antibacterial drugs.
引文
[1]潘京京.西安市14所医院Ⅰ类手术切口抗菌药物预防性应用分析[J].中华医院感染学杂志,2016,26(6):1397-1399,1403.
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[3]陈锋,马刚,肖识愚,等.四肢闭合性骨折Ⅰ类切口手术患者合理应用抗菌药物调查[J].中华医院感染学杂志,2017,27(15):3525-3528.
[4]王艳群.2012-2016年山东能源新汶矿业集团莱芜中心医院Ⅰ类切口手术围术期预防性应用抗菌药物调查与分析[J].中国医院用药评价与分析,2017,17(8):1108-1111.
[5]史志学.外科Ⅰ类切口手术围术期预防性应用抗菌药物的情况调查以及合理性分析[J].中国医院用药评价与分析,2016,16(2):231-234.
[6]马秀珍.某三甲医院2013-2016年Ⅰ类切口手术围术期抗菌药物预防使用情况的调查分析[J].中华预防医学杂志,2018,52(4):436-437.
[7]刘海燕,张琳琳,安佰龙,等.355例骨科Ⅰ类切口手术围术期预防性应用抗菌药物的调查与分析[J].中国医院用药评价与分析,2016,16(8):1120-1122.
[8]冒群,徐爱宁.某医院2016年Ⅱ类切口围手术期预防性应用抗菌药物的合理性分析[J].解放军预防医学杂志,2017,35(10):1301-1303.
[9]杨文芬.Ⅰ类切口手术预防性应用抗菌药物情况分析[J].中国城乡企业卫生,2017,10(3):1-4.
[10]孙晓茜,周协涛.普外科Ⅰ类切口手术预防性应用抗菌药物情况分析[J].中国现代医药杂志,2017,23(12):97-99.
[2]常恩,白映涛.我院2015~2016年Ⅰ类切口手术围术期预防性使用抗菌药物的调查分析[J].临床合理用药杂志,2017,10(19):3-4.
[3]陈锋,马刚,肖识愚,等.四肢闭合性骨折Ⅰ类切口手术患者合理应用抗菌药物调查[J].中华医院感染学杂志,2017,27(15):3525-3528.
[4]王艳群.2012-2016年山东能源新汶矿业集团莱芜中心医院Ⅰ类切口手术围术期预防性应用抗菌药物调查与分析[J].中国医院用药评价与分析,2017,17(8):1108-1111.
[5]史志学.外科Ⅰ类切口手术围术期预防性应用抗菌药物的情况调查以及合理性分析[J].中国医院用药评价与分析,2016,16(2):231-234.
[6]马秀珍.某三甲医院2013-2016年Ⅰ类切口手术围术期抗菌药物预防使用情况的调查分析[J].中华预防医学杂志,2018,52(4):436-437.
[7]刘海燕,张琳琳,安佰龙,等.355例骨科Ⅰ类切口手术围术期预防性应用抗菌药物的调查与分析[J].中国医院用药评价与分析,2016,16(8):1120-1122.
[8]冒群,徐爱宁.某医院2016年Ⅱ类切口围手术期预防性应用抗菌药物的合理性分析[J].解放军预防医学杂志,2017,35(10):1301-1303.
[9]杨文芬.Ⅰ类切口手术预防性应用抗菌药物情况分析[J].中国城乡企业卫生,2017,10(3):1-4.
[10]孙晓茜,周协涛.普外科Ⅰ类切口手术预防性应用抗菌药物情况分析[J].中国现代医药杂志,2017,23(12):97-99.