【摘要】：目的:評價臨床藥師干預(yù)骨折內(nèi)固定裝置取出術(shù)預(yù)防使用抗菌藥物的效果。方法:選取某"三甲"醫(yī)院2015年3-7月行骨折內(nèi)固定裝置取出術(shù)的患者117例為干預(yù)前組,2015年8月-2016年5月行上述手術(shù)的患者266例為干預(yù)后組。臨床藥師以該院《骨折內(nèi)固定裝置取出術(shù)預(yù)防使用抗菌藥物合理性評價標(biāo)準(zhǔn)》為依據(jù)進(jìn)行干預(yù),比較干預(yù)前后兩組患者預(yù)防使用抗菌藥物的情況。結(jié)果:干預(yù)前后均未發(fā)現(xiàn)單次給藥劑量不合理或需術(shù)中追加給藥的患者。干預(yù)后,患者預(yù)防用抗菌藥物使用率、無指征使用抗菌藥物的比例、用藥持續(xù)時間超過24 h的比例分別由干預(yù)前的84.6%、71.8%、48.7%下降至17.3%、9.8%、4.9%,且患者平均抗菌藥物費(fèi)用、全部藥品費(fèi)用占住院費(fèi)用的比例和抗菌藥物占全部藥品費(fèi)用的比例均較干預(yù)前顯著降低,差異均有統(tǒng)計學(xué)意義(P0.05);而干預(yù)前后藥物選擇不合理、首次預(yù)防用藥時機(jī)不合理、聯(lián)合用藥不合理的患者比例,使用不同抗菌藥物品種的比例,平均住院費(fèi)用以及平均藥品費(fèi)用比較,差異均無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:臨床藥師的干預(yù)顯著降低了骨折內(nèi)固定裝置取出術(shù)患者預(yù)防用抗菌藥物的使用率,并改善了無指征用藥情況,提高了預(yù)防使用抗菌藥物的合理性;但仍然存在用藥時機(jī)不合理、持續(xù)使用時間超過24 h等現(xiàn)象,仍需后續(xù)持續(xù)干預(yù)。
[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.
【作者單位】： 南京醫(yī)科大學(xué)藥學(xué)院;南京醫(yī)科大學(xué)附屬明基醫(yī)院資材管理部;南京醫(yī)科大學(xué)醫(yī)政學(xué)院;
【基金】：國家自然科學(xué)基金面上項目(No.71673147);國家自然科學(xué)基金青年項目(No.71003055)
【分類號】：R687.3
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本文編號：2500512