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目的:促进外科围手术期抗菌药合理应用。方法:临床药师负责抗菌药物知识培训、应用指导及动态监测,医院感染管理科加强管理考核,管教结合,综合干预,使外科围手术期抗菌药应用持续改进。结果:与对照组比,干预组清洁手术一代头孢使用率明显提高(P<0.01),三代头孢、喹诺酮类使用率明显降低(P<0.01),术前0.5～2 h首次用药率明显升高(P<0.01),术后平均用药天数明显减少(P<0.01);清洁-污染手术喹诺酮类使用率明显降低(P<0.01),术后持续用药≤24 h病例数明显增加(P<0.05);两组术后并发感染和存在感染征象的发病率无差异(P>0.05)。结论:临床药师与医院感染管理科联合干预,对外科围手术期抗菌药合理应用安全、有效。
Objective: To promote the rational use of perioperative antibacterials in surgery. Methods: The clinical pharmacists were responsible for the training of antimicrobial agents knowledge, application guidance and dynamic monitoring, and the Hospital Infection Management Division to strengthen the management assessment, discipline and education, and comprehensive intervention so that the application of perioperative antibacterials could be continuously improved. Results: Compared with the control group, the use rate of cephalosporins in the surgeries of the intervention group was significantly increased (P <0.01), and the rates of cephalosporins and quinolones of the third generation were significantly decreased (P <0.01) (P <0.01), and the average number of days after operation was significantly decreased (P <0.01). The use of quinolone was significantly decreased (P <0.01), and the number of continuous medication ≤24 h after operation was significantly increased (P <0.05 ). There was no difference in the incidence of postoperative infection and infection signs between the two groups (P> 0.05). Conclusion: The combination of clinical pharmacists and hospital infection management department is safe and effective for the rational application of perioperative antibacterials.