降低我院产科抗菌药物使用强度的方法研究

摘要

OBJECTIVE: To provide reference for reducing the antibacterial use density (AUD) in the obstetric department of medical institutions. METHODS: It was statistically analyzed that the number of obstetric discharged patients, average hospital stay, prophylactic application of antibiotics in obstetric delivery patients and the amount of antibiotics from information center of our hospital during Nov. 2010 to Mar. 2011 (before intervention) and Apr. 2011 to Aug. 2011 (after intervention). Taking DDD as the unit, AUD of antibiotics were calculated by the value of DDDs/100 persons/day. RESULTS: Before and after intervention, the number of prophylactic application of antibiotics in obstetric delivery patients were 91.13% and 92.78% of total number, the rates of prophylactic application of antibiotics in cesarean delivery patients were 92.15% and 92.07%, the courses of vaginal delivery patients were 1.91 days and 1.93 days. The course of cesarean delivery patients was 1.91 days and prophylactic application rate of antibiotics in vaginal delivery patients was 66.41% after intervention, which was significantly lower than 2.91 days and 96.92% before intervention (P＜0.05). The AUD were 77 DDDs/100 persons /day and 53 DDDs/100 persons /day before and after intervention, in decreasing tendency month by month. The AUD of the second-generation cephalosporin was the highest. CONCLUSION: It could reduce the AUD of antibiotics in obstetric department that the course of cesarean delivery patients has been shortened and the rate of prophylactic application of antibiotics in vaginal delivery patients has been reduced. There is unreasonable choice of prophylactic antibiotics in the obstetric delivery patients. It is necessary to strengthen the management of antibiotics use.%目的:为降低产科抗菌药物的使用强度(AUD)提供参考.方法:从我院信息中心统计2010年11月-2011年3月(整治前)和2011年4-8月(整治后)产科出院患者人数、平均住院时间、分娩患者预防用抗菌药物情况和抗菌药物用量；以约定日剂量(DDD)为单位,以DDDs/100人/天计算抗菌药物的AUD.结果:整治前、后预防用抗菌药物分娩患者分别占产科抗菌药物使用人数的91.13％和92.78％,剖宫产患者预防用抗菌药物比例分别为92.15％和92.07％,经阴道分娩预防用抗菌药物疗程分别为1.91d和1.93 d.整治后,剖宫产患者预防用抗菌药物疗程为1.91 d,经阴道分娩患者抗菌药物预防应用率为66.41％,均比整治前的2.91 d和96.92％显著降低(P＜0.05).整治前、后AUD分别为77、53 DDDs/100人/天,呈逐月降低趋势.第2代头孢菌素的AUD最大.结论:缩短剖宫产患者预防用抗菌药物疗程和降低经阴道分娩患者抗菌药物的预防使用比例可降低产科抗菌药物的AUD.产科分娩患者预防用抗菌药物的品种选择不合理,需继续加强管理.