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Status of Application of Antibiotics in Perioperative Prophylactic Use and Contrast Studies of Intervention

Author: ZengDaYong
Tutor: WangChangLian
School: Fujian Medical
Course: Pharmacology
Keywords: Perioperative Antimicrobial drugs Prophylaxis Survey Intervention -control study
CLC: R96
Type: Master's thesis
Year: 2010
Downloads: 261
Quote: 2
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Abstract

Objective: a survey in a hospital perioperative antimicrobial prophylaxis application status, analysis of existing problems and the reasons for the findings to surgeons and medical management feedback and proposed drug intervention programs. (2) intervention-control study. Observation and analysis of drug interventions on surgical site infection and the incidence of nosocomial infections; economics from the drug explore interventions on health care costs (including antibacterial drug costs) effects; explore interventions on clinical impact of adverse drug events; rational use of drugs for clinical and administrative functions of the department to provide a reference. 3 study focused interventions and how to effectively continue to promote rational drug use. Methods: 1.I class incision thyroid surgery, breast surgery and laparoscopic cholecystectomy, II-incision cesarean section. According to the Ministry of Health issued the relevant policies, according to the purpose of the survey, designed to investigate the evaluation form. Bring up a hospital 2009.01 ~ September surgery was discharged four records, according to uniform standards qualified medical screening copies of 1876, using the questionnaire items are investigated, analyzed and evaluated. Collect data using Excel entry, data with spssll.5 descriptive statistical analysis. 2 Select the thyroid, breast and laparoscopic cholecystectomy intervention-control study. The 2009.07 ~ 09 months were randomly divided into normal working day and non-intervention intervention days. Day surgery intervention prophylactic antibiotics intervention programs according to the set of cases selected for the intervention group. Non-intervention in day surgery conducted by the daily dosing regimen, selected control group. Intervention group and control group were 20 cases the number of cases. Comparative analysis of the two groups of antimicrobial agents varieties to choose from, combination therapy, the use of species number, timing premedication, intraoperative additional administration, the number of days medication, medication dosages for surgical site infection rate, length of stay, cost implications. Measurement data between the two groups were compared using two independent samples t-test, the results of x ± S represents; count data were compared using χ2 test, with P lt; 0.05 was considered statistically significance. Results: 1.1876 cases surgery all use of antimicrobial agents, both preventive medication, accounting for 100%. Antimicrobial drugs used in 18 species of 10. 679 cases of improper selection of species, accounting for 36.2 percent, which involves the restrictive use of antibiotics 339 cases, accounting for 18.1%; involve special use of antimicrobial drugs 145 cases, accounting for 7.7%; during hospitalization average 1.1 kinds of use of antimicrobial agents, antimicrobials rate 1.8%, no replacement drugs based on 139 cases, accounting for 7.4%; fails preoperative 0.5 ~ 2h start medication in 14 cases, accounting for 0.7%; average number of days 2.5 days medication, postoperative medication for too long 1,228 cases, accounting for 65.5%; single overdose 120 cases, accounting for 6.4%. (2) three types of surgical intervention and control groups in all patients nosocomial infection, surgical site infection, adverse reaction rates are 0, there is no difference. Three types of surgical intervention group compared with the control group, the average length of stay, hospital costs, drug costs, antibacterial drugs costs were significant differences (P lt; 0.05). Thyroid surgery in the treatment course and variety selection rationality, the intervention group than the control group, the difference was statistically significant (P lt; 0.05); breast surgery and laparoscopic cholecystectomy in rational drug selection of species, the intervention group were excellent in the control group, the difference was statistically significant (P lt; 0.01). Conclusion: Surgical hospital rational use of antibiotics in patients with many problems. Mainly in the grasp of perioperative antimicrobial prophylaxis indications not strictly prevent the application rate is high, especially in type Ⅰ incision thyroid surgery, breast surgery antimicrobial application rates up to 100%. There are still high levels of preventive medication varieties, preventive medication for too long, too large single dose of medication and other issues. Cesarean section irrational antibiotic prophylaxis is particularly prominent. The future should take specific and effective measures to ensure the management of perioperative rational use of antimicrobial agents, focusing on strengthening preventive antibiotic selection of species regulation, a single dose of rational treatment and prevention of norms, in order to facilitate reduction of resistant bacteria produce, reduce the financial burden of patients, improve the level of rational drug use.

Status of Application of Antibiotics in Perioperative Prophylactic Use and Contrast Studies of Intervention

Abstract

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