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目的:评价行政督导对Ⅰ类切口围术期预防应用抗菌药物的效果,提高抗菌药物临床合理应用率。方法:随机选取2011年和2013年外科手术治疗的患者127例和113例,均为Ⅰ类切口,2012年实施行政督导,比较干预前后的抗菌药物临床应用不合理率、不合理内容和住院时间及治疗费用情况。结果:不合理率干预前为96.85%,干预后为36.28%,差异具有统计学意义(P<0.05)。干预前后无用药指征、药物选择不适宜、剂量错误、频次错误、溶剂选择不当、给药途径不当、用药时机不当、用药疗程不当、联合用药不当和更换药物无依据的比重经比较差异均具有统计学意义(P<0.05)。干预前和干预后住院时间、总治疗费用、总药物费用、抗菌药物费用、抗菌药物占总治疗费用比例和抗菌药物占总药物费用比例经比较差异均具有统计学意义(P<0.05)。结论:行政督导能明显提高Ⅰ类切口围术期预防应用抗菌药物的合理应用率,降低治疗费用。
OBJECTIVE: To evaluate the effect of administrative supervision on prevention and treatment of antimicrobial agents in perioperative period of type Ⅰ incision and to improve the clinical application rate of antimicrobial agents. Methods: 127 cases and 113 cases of surgical treatment in 2011 and 2013 were randomly selected. All of them were class Ⅰ incisions. In 2012, they were supervised by the administrative supervisor to compare the irrational clinical application of antibacterials before and after the intervention, unreasonable content and hospital stay And treatment costs. Results: The unreasonable rate was 96.85% before intervention and 36.28% after intervention, the difference was statistically significant (P <0.05). Intervention before and after no indication of drug use, drug selection is not appropriate, the wrong dose, the wrong frequency, improper solvent selection, improper route of administration, improper medication timing, improper medication, improper combination of drugs and replacement of drugs based on the differences were compared with the differences Statistical significance (P <0.05). Pre-intervention and post-intervention hospitalization time, total treatment costs, total drug costs, antimicrobial drug costs, the proportion of antimicrobial drugs in total treatment costs and the proportion of antimicrobial drugs in total drug costs were statistically significant differences (P <0.05). Conclusion: Administrative supervision can obviously improve the reasonable application rate of antimicrobial agents in class I perioperative period and reduce the treatment cost.