临床药师干预眼科清洁手术围术期抗菌药物应用效果分析

目的:评价临床药师对眼科清洁手术围术期抗菌药物预防用药的干预效果。方法:通过行政干预与技术干预相结合的综合干预策略,对对照组(2011年1-8月清洁手术患者出院病历401份)、干预组1(2012年1-8月清洁手术患者出院病历417份)和干预组2(2013年1-8月清洁手术患者出院病历437份)围术期预防使用抗菌药物情况进行合理性评价及统计学分析。结果:经过综合干预,3个阶段围术期抗菌药物用药指标均有明显改善,抗菌药物预防使用率从对照组的20.70%下降至干预组的5.76%和12.13%(P<0.05);无适应证用药率从4.20%下降至0.48%和1.14%(P<0.01);抗菌药物品种选择不合理率从16.21%下降至1.68%和0.46%(P<0.01);用药时机不合理率从13.22%下降至1.92%和0(P<0.05);平均用药疗程从(2.80±2.70)d下降至(2.56±1.56)d(P>0.05)和(1.52±1.39)d(P<0.05)。结论:通过综合干预措施,可有效提高眼科清洁手术围术期抗菌药物应用的合理性。

Effect Analysis of Perioperative Application of Antimicrobials in Clean Operations of Ophthalmology under Clinical Pharmacist Intervention

OBJECTIVE： To evaluate the effects of intervention on the perioperative prophylactic application of antimicrobials in clean operations of ophthalmology by clinical pharmacist. METHODS： By carrying out administrative intervention combined with technology intervention, the rationality of perioperative prophylactic application of antimicrobials was evaluated and analyzed statistically in control group （401 discharge medical records of clean surgery patients during Jan.--Aug. in 2011）, intervention group I （417 discharge medical records of clean surgery patients during Jan.--Aug. in 2012） and intervention group II （437 discharge medical records of clean surgery patients during Jan.--Aug. in 2013）. RESULTS： After comprehensive intervention, the indexes of antimicrobial use in the 3 phases were all improved significantly. Prophylactic application rate of antimicrobials decreased from 20.70% in control group to 5.76% and 12.13% in intervention groups （P〈0.05）;the rate of no indications of medication decreased from 4.20% to 0.48% and 1.14% （P〈0.01）; the rate of irrational drug selection decreased from 16.21% to 1.68% and 0.46% （P〈0.01） ;the rate of irrational medication timing decreased from 13.22% to 1.92% and 0 （P〈0.05） ;the average course of treatment decreased from （2.80± 2.70） d to （2.56± 1.56）d （P〉0.05） and （1.52 ± 1.39） d （P〈0.05）. CONCLUSIONS： The application of comprehensive intervention measures by clinical pharmacist can improve the rationality of perioperative prophylactic application of antimicrobials in clean operations of ophthalmology.