临床药师利用循证医学证据干预普外科围手术期应用抗菌药物效果

目的探讨临床药师应用临床研究证据对普外科医师围手术期应用抗菌药物的干预效果。方法随机抽取我院2009年9月至2010年9月和2011年9月至2012年9月普外科手术后出院患者病历各60份。设计《外科手术围术期抗菌药物使用调查表》，临床药师查阅文献，结合临床证据进行宣教，提供较高证据级别文献供医生参考。对比临床药师干预前后普外科围手术期抗菌药物品种、时间、联合用药等情况。结果临床药师结合临床证据进行干预后，普外科围手术期抗菌药物选择、给药时机、术后用药、用法用量的合理比例较干预前明显升高，分别为70％（42／60）与50％（30／60）（P〈0．05），97％（58／60）与52％（31／60）（P〈0．05），82％（49／60）与48％（29／60）（P〈0．05），87％（52／60）与80％（48／60）（P〉0．05）。结论临床药师通过检索文献，应用临床证据对医生提供有效的宣教和干预，能够更好地提高普外科围手术期抗菌药物使用合理率。

Survey of clinical pharmacist intervening in prophylactic application of antibiotics during perioperative period in general surgery department

Objective To investigate the effect of clinical pharmacists intervening with clinical evidence in prophylactic application of antibiotics during perioperative period in surgery department. Methods Totally 60 medi- cal records were collected during September 2009 and September 2010 （former intervention）and September 2011 and September 2011 （ new intervention）, respectively. Questionnaire of surgical perioperative antimicrobial drug use was designed. Clinical pharmacists provided a high level of evidence literature for physicians through combined literature with clinical evidence missionary. The rationality of perioperative prophylactic application of antibiotics was com- pared in terms of antibiotics indication, medicine selection, usage and dosage, administration time and treatment course. Results After intervention of clinical pharmacists, the perioperative prophylactic application of antibiotics was improved significantly in respects of medicine selection, administration time, dosage and usage[ 70% （42/60） vs 50% （30/65 （P 〈0. 05）, 97% （58/60） vs （52% （31/60） （P 〈0.05）, 82% （49/60） vs 48% （29/60） （P 〈 O. 05）, 87% （52/60） vs 80% （48/60） （P 〉 0. 05）]. Conclusion It is effective and practicable for clinical pharmacists to intervene with clinical evidences in prophylactic application of antibiotics during perioperative period in general surgery department.