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目的:比较临床药师干预前后清洁手术围术期患者预防性使用抗菌药物的疗效。方法:分别抽取2012年2—7月期间的清洁手术患者140例(未干预组)以及2013年2—7月期间的清洁手术患者140例(干预组),分析临床药师干预前后清洁手术围手术期患者预防性使用抗菌药物的合理性。结果:干预组患者预防给药时机的合理性明显高于未干预组;抗菌药物的预防性使用率、给药疗程、药物选择种类、联合用药百分比以及抗菌药物费用均明显低于未干预组(P<0.05);综合干预后抗菌药物使用率由80.71%降至36.43%;用药指征、药物的选择、用药时机的合理率显著升高(P<0.05);干预后用法用量的合理率从87.61%上升到94.12%;联合用药情况从18.58%降至1.96%;抗菌药物费用占总用药费用比下降了5.87%;平均用药时间为(4.03±0.61)d,干预后用药时间为(2.80±0.13)d,较干预前有所缩短。结论:临床药师对清洁手术围术期患者预防性使用抗菌药物的干预,有助于促进抗菌药物的合理使用,促进了医疗资源的合理分配和优化。
OBJECTIVE: To compare the efficacy of prophylactic use of antibacterials in patients undergoing perioperative clean-up before and after clinical pharmacist intervention. Methods: 140 cases (no intervention group) of patients undergoing clean operation and 140 cases of clean operation during the period from July to July in 2013 (intervention group) were selected from January to July 2012 respectively. The clinical data of patients undergoing clean operation before and after the intervention of clinical pharmacists Period of prophylactic use of antimicrobial drugs rationality. Results: The rationality of prophylaxis in the intervention group was significantly higher than that in the non-intervention group. The prophylactic use rate of antibacterials, the course of medication, the type of drug choice, the percentage of combination medication and the cost of antibacterial drugs were significantly lower than those in the non-intervention group P <0.05). The comprehensive utilization of antibacterials decreased from 80.71% to 36.43%. The reasonable rates of medication indications, drug selection and medication timing were significantly increased (P <0.05) 87.61% to 94.12%; the combination medication decreased from 18.58% to 1.96%; the cost of antimicrobial drugs was 5.87% of the total cost of medication; the average medication time was (4.03 ± 0.61) days; the medication time was (2.80 ± 0.13) d, which was shorter than before intervention. Conclusion: The intervention of clinical pharmacists on prophylactic use of antimicrobial agents in perioperative patients with clean surgeries helps to promote the rational use of antimicrobial agents and promote the rational distribution and optimization of medical resources.