2019 年第 3 期 第 14 卷

药师干预剖宫产围术期抗菌药物预防性应用效果分析

Effect of prophylactic application of antibiotics intervened by pharmacists during perioperative period of cesarean section

作者：姚敏李文武杨勇

英文作者：

单位：641300四川省资阳市人民医院药学部（姚敏、李文武）；610072成都，四川省人民医院药学部（杨勇）

英文单位：

关键词：剖宫产术；抗菌药物；药学干预；围手术期

英文关键词：

• 摘要：

• 【摘要】目的    分析药师干预剖宫产围术期抗菌药物预防性应用的效果。方法    回顾性调查四川省资阳市人民医院660例患者剖宫产围术期抗菌药物应用情况，按干预时段分为干预前组（2015年1—6月，236例）、干预中组（2016年1—6月，230例）和干预后组（2017年1—6月，194例），对3组剖宫产围术期抗菌药物品种选择、给药时机、用药疗程、用法用量、抗菌药物平均费用等进行对比分析。结果    通过药学干预，四川省资阳市人民医院剖宫产术围术期抗菌药物选择趋于合理，特别是头孢唑啉钠的使用率显著提高［干预前组为0，干预后组为18.6%（36/194）］，用法用量逐步规范合理。术后用药疗程明显缩短，≤24 h的比例干预前组、干预中组、干预后组分别为9.8%（23/236）、48.3%（111/230）、82.0%（159/194），3组间两两比较差异均有统计学意义(均P<0.05)。抗菌药物人均费用大幅下降，干预后组与干预前组差异有统计学意义［（101±100）元比（289±122）元］（P<0.05）。结论    通过药学持续干预，四川省资阳市人民医院剖宫产围术期抗菌药物应用的合理性显著改善，干预效果明显。

• 【Abstract】Objective    To analyze the effect of pharmacist intervention on prophylactic use of antibiotics during perioperative period of cesarean section. Methods    A retrospective investigation was performed in 660 patients who had cesarean section in Ziyang People′s Hospital of Sichuan Province. Antibiotics were used during perioperative period. According to the time of pharmacist intervention, the patients were divided into three groups: pre-intervention group(236 cases, between January and June 2015), intervention group(230 cases, between January and June 2016) and post-intervention group(194 cases, between January and June 2017). Choice of antibiotic species, timing of administration, course, usage, dosage and cost of drugs were analyzed. Results    Choice of antibiotics during perioperative period of cesarean section tended reasonable after pharmaceutical intervention. Use rate of cefazolin sodium was significantly improved［pre-intervention 0 vs post-intervention 18.6%（36/194）］ and the dosage were standardized. Course of medication was significantly shortened; proportions of the course≤24 h in pre-intervention group, intervention group and post-intervention group were 9.8%(23/236), 48.3%(111/230) and 82.0%(159/194), respectively; there were significant differences among the three groups(all P<0.05). Cost of antibiotics per capita significantly decreased; there was a significant difference between post-intervention group and pre-intervention group［（101±100）yuan vs （289±122）yuan］（P<0.05）. Conclusion    Rational use of antibiotics during perioperative period of cesarean section can be significantly improved through pharmaceutical intervention.