我院特殊诊疗操作中预防性使用抗菌药物调查分析
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篇名: 我院特殊诊疗操作中预防性使用抗菌药物调查分析
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摘要: 目的:调查我院特殊诊疗操作中预防性使用抗菌药物的情况,为抗菌药物合理使用提供参考。方法:收集我院2016年1-8月进行特殊诊疗操作的患者,对其预防性使用抗菌药物的情况进行统计、分析。结果:纳入调查的149例患者中,有62例预防性使用了抗菌药物,使用率为41.61%。62例使用抗菌药物的患者中,有5例为口服,其余均为注射给药。共使用抗菌药物九大类18个品种,合计69例次,其中头孢菌素类使用频次为49例次(71.01%),头孢菌素类使用频次最高的3个品种依次为头孢地嗪、头孢替安和头孢唑林。其中,血管(包括冠状动脉)造影术、支架植入术均未预防性使用抗菌药物;其他诊疗操作的抗菌药物预防性使用率均超过50%;输尿管镜和膀胱镜检查、震波碎石术的预防性使用抗菌药物情况较复杂,且选药品种起点较高。单一用药59例(95.16%);二联用药3例(4.84%)。用药时机为术前0.5~2 h或麻醉开始时有41例(66.13%)。用药持续时间≤24 h的有18例(29.03%);>24~48 h 的有11例(17.74%)。结论:我院血管(包括冠状动脉)造影术、支架植入术和腹膜透析管植入术符合预防性使用抗菌药物规范;其他特殊诊疗操作存在给药指征把握不严、药物选择起点过高和给药时机不适宜及疗程偏长等问题。
ABSTRACT: OBJECTIVE: To investigate the use of prophylactic use of antibiotics for special diagnosis and treatment in our hospital, and to provide reference for rational use of antibiotics. METHODS: The patients receiving special diagnosis and treatment were collected from our hospital during Jan.-Aug. 2016. The prophylactic application of antibiotics was analyzed statistically. RESULTS: Among 149 included patients, there were 62 cases of prophylactic use of antibiotics with utilization rate of 41.61%. Among 62 patients receiving antibiotics, 5 cases were given medicine orally and others were via injection. Nine categories 18 types of antibiotics were used, involving 69 times; cephalosporin were used in 49 times (71.01%), among which top 3 types in the list of use sequence were cefodizime, cefotetan and cefazolin; prophylactic use of antibiotics was not found in angiography (including coronary artery) and stent implantation. Utilization rate of antibiotics for other diagnosis and treatment was more than 50%. The prophylactic use of antibiotics was complex in ureteroscopy and cystoscopy, shock wave lithotripsy; the selection of drug types started from the high level. There were 59 cases of single drug (95.16%) and 3 cases of two-drug (4.84%). Total of 41 cases were given medicine 0.5-2 h before surgery or at the beginning of anaesthesia (66.13%). Medication time of 18 cases was ≤24 h (29.03%); that of 11 cases was >24-48 h (17.74%). CONCLUSIONS: The prophylactic use of antibiotics is relatively standard in angiography (including coronary artery), stent implantation and implantation of peritoneal dialysis tube in our hospital. There are some problems during special diagnosis and treatment, such as the indication of drug delivery is not strict; the selection of drug types starts from the high level; medication timing is not suitable; medication course is excessively long.
期刊: 2017年第28卷第26期
作者: 邵燕,刘群,张东萍,巫爱峰,陈丽芳
AUTHORS: SHAO Yan,LIU Qun,ZHANG Dongping,WU Aifeng,CHEN Lifang
关键字: 特殊诊疗操作;预防性使用;抗菌药物;合理用药
KEYWORDS: Special diagnosis and treatment; Prophylactic use; Antibiotics; Dational durg use
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