今日药学

2020, v.30(03) 194-196+208

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临床药师对我院剖宫产围术期预防使用抗菌药物的干预效果
The Intervention Effect of Clinical Pharmacists on Prophylactic Antibiotic for Cesarean Delivery

王丽;董雪;李林楷;杨富恒;李振东;
WANG Li;DONG Xue;LI Linkai;YANG Fuheng;LI Zhendong;Zhuhai Maternal and Child Health Hospital;

摘要(Abstract):

目的调查干预前后剖宫产围术期抗菌药物使用情况,研究临床药师在剖宫产围术期抗菌药物预防性应用中的作用。方法通过HIS调取干预前3个月(2018年7~9月),第一级阶段干预组(2018年11月~2019年1月),第二阶段干预组(2019年2~4月)的剖宫产手术病例,采用回顾性分析的方法,研究临床药师干预前后对抗菌药物品种选择、联合用药情况、给药时机、术后用药天数的影响。结果经过两轮干预患者预防性使用抗菌药物用药时机合理率由0%上升至80.56%(P<0.05),干预前头孢孟多和奥硝唑使用频率最高,干预后头孢唑林和头孢拉定使用比例从46.54%升至96.34%,二联用药比例由40.92%下降至19.71%。干预前后预防用药疗程超48 h患者比例由100%降至90.14%,两者比较差异无统计学意义(P>0.05)。切口感染率由1.02%降至0.56%。结论通过临床药师的积极干预,我院剖宫产围手术期抗菌药物合理率改善显著,但术后用药天数过长,需要临床药师进一步干预。
OBJECTIVE To investigate the use of antibiotics before and after intervention in the perioperative period of cesarean section and to study the role of clinical pharmacists in the prophylactic antibiotics use during cesarean section. METHODS Patients undergoing cesarean section were divided into pre-intervention group(July to September,2018),the first stage intervention group(November to December 2018,January 2019) and the second stage intervention group(February to April 2019) according to whether clinical pharmacists intervened. Retrospective analysis was conducted to study the effects of clinical pharmacists before and after intervention on the selection of antibacterial drugs,the status of combined drug use,the timing of drug administration,and the duration of postoperative drug use. RESULTS After two-ronud intervention,the appropriate timing of Initial dose increased from 0% to 80.56%.Choice of cefradine and cefazolin increased from 46. 54% to 96. 34%. The combined use of two antibiotics decreased from 40. 92% to19.71%.The duration of medication over 48 hours decreased from 100.0% to 90.14%.The incisional infection decreased from 1.02% to 0.56%. CONCLUSION The intervention by clinical pharmacists can significantly improve antimicrobial prophylaxis in patients undergoing cesarean section in our hospital,however,the long duration of postoperative medication required further intervention.

关键词(KeyWords): 剖宫产术;干预;抗菌药物;预防用药
cesarean section;intervention;antibiotics;prophylactic use

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基金项目(Foundation): 珠海市科技计划医疗卫生项目(20181117E030087)

作者(Author): 王丽;董雪;李林楷;杨富恒;李振东;
WANG Li;DONG Xue;LI Linkai;YANG Fuheng;LI Zhendong;Zhuhai Maternal and Child Health Hospital;

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