临床药师干预骨折内固定装置取出术预防使用抗菌药物的效果评价与分析

发布时间：2019-06-15 21:00

【摘要】：目的:评价临床药师干预骨折内固定装置取出术预防使用抗菌药物的效果。方法:选取某"三甲"医院2015年3-7月行骨折内固定装置取出术的患者117例为干预前组,2015年8月-2016年5月行上述手术的患者266例为干预后组。临床药师以该院《骨折内固定装置取出术预防使用抗菌药物合理性评价标准》为依据进行干预,比较干预前后两组患者预防使用抗菌药物的情况。结果:干预前后均未发现单次给药剂量不合理或需术中追加给药的患者。干预后,患者预防用抗菌药物使用率、无指征使用抗菌药物的比例、用药持续时间超过24 h的比例分别由干预前的84.6%、71.8%、48.7%下降至17.3%、9.8%、4.9%,且患者平均抗菌药物费用、全部药品费用占住院费用的比例和抗菌药物占全部药品费用的比例均较干预前显著降低,差异均有统计学意义(P0.05);而干预前后药物选择不合理、首次预防用药时机不合理、联合用药不合理的患者比例,使用不同抗菌药物品种的比例,平均住院费用以及平均药品费用比较,差异均无统计学意义(P0.05)。结论:临床药师的干预显著降低了骨折内固定装置取出术患者预防用抗菌药物的使用率,并改善了无指征用药情况,提高了预防使用抗菌药物的合理性;但仍然存在用药时机不合理、持续使用时间超过24 h等现象,仍需后续持续干预。
[Abstract]:Objective: to evaluate the effect of clinical pharmacist intervention on the removal of fracture internal fixation device to prevent the use of antibiotics. Methods: 117 patients who underwent fracture internal fixation from March to July 2015 were selected as the pre-intervention group and 266 patients who underwent the above operation from August 2015 to May 2016 as the intervention group. The clinical pharmacists intervened on the basis of the criteria for evaluating the rationality of preventing the use of antibiotics in the extraction of fracture internal fixation devices, and compared the prophylactic use of antibiotics between the two groups before and after the intervention. Results: no patients with unreasonable single dose or additional intraoperative administration were found before and after intervention. After intervention, the utilization rate of prophylactic antibiotics and the proportion of patients who used antibiotics without indication were 84.6%, 71.8%, 48.7%, 9.9% and 4.9%, respectively, from 84.6%, 71.8%, 48.7% and 4.9%, respectively, and the average cost of antibiotics was 4.9%. The proportion of all drug costs to hospitalization expenses and the proportion of antibiotics to all drug costs were significantly lower than those before intervention, the difference was statistically significant (P 0.05). However, there was no significant difference in the proportion of patients with unreasonable choice of drugs before and after intervention, unreasonable timing of first prophylaxis, unreasonable combination of drugs, proportion of using different antibiotics, average hospitalization cost and average drug cost (P 0.05). Conclusion: the intervention of clinical pharmacists can significantly reduce the utilization rate of prophylactic antibiotics in patients with fracture internal fixation, improve the situation of unindicated use of antibiotics, and improve the rationality of preventive use of antibiotics, but there are still some phenomena, such as unreasonable timing of drug use and continuous use of antibiotics for more than 24 hours, which still need continuous intervention.
【作者单位】： 南京医科大学药学院;南京医科大学附属明基医院资材管理部;南京医科大学医政学院;
【基金】：国家自然科学基金面上项目(No.71673147);国家自然科学基金青年项目(No.71003055)
【分类号】：R687.3
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本文编号：2500512