临床药师干预前后普外科抗菌药物临床应用情况对比研究

摘要

Objective:To investigate the effect on the clinical pharmacist before and after the intervention of antibiotics use in the department of general surgery.Methods:Respectively extracted hospital 2012-2014 in July.-Dec. of antimicrobial agents of all records in general surgery, the indexes were analyzed statistically, including antibiotics cost per capita of inpatients, the proportion of antibiotics cost in total drug cost, the proportion of antibiotics in the inpatients, AUD of inpatients, the pathogenic detection rate of inpatients and the use of antimicrobial agents for perioperative prophylaxis. Comparative analysis was performed before and after the intervention of antimicrobial agents use.Results:After the intervention, the evaluation indexes in clinical use of antibiotics were improved significantly, especially in perioperative prophylaxis. Among them, the use of typeⅠincision prophylactic antibiotics in the intervention Phase 2 was 97.20%, down to 30.23% after the intervention, a decline of 68.90 percent, basically reached the requirements of the Ministry of Health. Type II incision operation prevention with the use of antibacterial agents in the second phase of intervention was 100%, after the intervention fell to 62.07%, a decline of 37.93%, suggestive a significant intervention.Conclusion:The proportion of unreasonable use of antibiotics in the department of general surgery after clinical pharmacist intervention is obviously lower, but it still needs to further standardize the management and improve the level of drug use.%目的：探讨临床药师干预前后对普外科使用抗菌药物的影响。方法：分别抽取我院2012-2014年7月-12月普外科抗菌药物应用所有病历，对住院患者人均应用抗菌药物费用、抗菌药物费用占药费总额的比例、住院患者抗菌药物使用率、住院患者抗菌药物使用强度(A U D)、住院患者病原学送检率、围手术期患者预防用抗菌药物使用率等6项指标进行分类统计，对比分析干预前后抗菌药物使用情况。结果：在实施干预后抗菌药物临床应用各项评价指标均改善明显，尤以围手术期预防用药为著。其中，Ⅰ类切口手术预防用抗菌药物使用率干预第2阶段为97.20%，干预后降至30.23%，降幅68.90%，基本达到卫生部要求。Ⅱ类切口手术预防用抗菌药物使用率干预第2阶段为100%，干预后降至62.07%，降幅37.93%，干预效果显著。结论：临床药师干预后普外科抗菌药物不合理使用比例明显降低，但仍需进一步规范管理，提高合理用药水平。