首页|2017-2022年上海市107所医疗机构Ⅰ类手术切口围术期抗菌药物预防使用状况

2017-2022年上海市107所医疗机构Ⅰ类手术切口围术期抗菌药物预防使用状况

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目的 调查上海市二级甲等及以上医疗机构Ⅰ类手术切口围术期抗菌药物的应用情况，为规范抗菌药物合理应用提供理论依据。方法 回顾性收集上海市2017-2022年107所医院Ⅰ类手术切口患者基本信息、围术期抗菌药物预防性使用率、用药类别、合理性及使用天数等并进行综合分析。结果 共纳入患者319 556例，2017-2022年抗菌药物预防使用率分别为32。95％、30。79％、29。99％、32。57％、30。63％和24。89％;三甲和三乙综合医院预防使用率总体呈上升趋势且差异有统计学意义(P＜0。05)。术前抗菌药物种类合理用药率2017-2019年为81。98％，2020-2022年上升至84。03％，三甲综合医院和三甲中医医院用药合理率偏低。总体术后抗菌药物时长＞24 h比例有下降趋势，三甲中医院术后用药＞7 d的比例有所上升，差异有统计学意义(P＜0。05)。结论 上海市二级甲等及以上医院Ⅰ类切口围术期预防用药总体日趋规范，但使用类型和使用天数仍存在不合理现象，需重点加强三甲综合医院、三乙综合医院和三甲中医院的围术期预防用药情况监管，有效提升抗菌药物预防应用的规范性。
Prophylactic use of antibiotics for type Ⅰ incision surgery during perioperative period in 107 medical institutions of Shanghai from 2017 to 2022
OBJECTIVE To investigate the use of antibiotics for typeIincision surgery during perioperative period in secondary grade A or above medical institutions of Shanghai so as to provide theoretical basis for reasonable use of antibiotics.METHODS The baseline data,prophylactic utilization rate of antibiotics during perioperative period,medication categories,rationality and number of medication days were retrospectively collected from the patients who underwent type Ⅰ incision surgery in 107 hospitals of Shanghai from 2017 to 2022.RESULTS A total of 319 556 patients were enrolled in the study.The rate of prophylactic use of antibiotics was 32.95％in 2017,30.79％in 2018,29.99％in 2019,32.57％in 2020,30.63％in 2021,24.89％in 2022.The rate of prophylactic use of antibiotics generally showed an upward trend in the three-A and three-B hospitals,and there was significant difference(P＜0.05).The rate of reasonable use of antibiotics before surgery was 81.98％in 2017-2019,rising up to 84.03 in 2020-2022;the rate of reasonable use of antibiotics was relatively low in three-A general hospitals and three traditional Chinese medicine hospitals.The proportion of patients who were treated with antibiotics for more than 24 hours after surgery showed a downward trend,the proportion of patients who were treated with an-tibiotics for more than 7 days after surgery showed an upward trend in the three-A TCM hospitals,and there was significant difference(P＜0.05).CONCLUSION The perioperative prophylactic use of antibiotics for type Ⅰ inci-sion surgery is increasingly standardized,however,there are unreasonable situation in type selection and treatment duration.It is necessary to strengthen supervision of perioperative prophylactic use of antibiotics in three-A general hospitals,three-B general hospitals and three-A TCM hospitals so as to effectively improve the reasonable prophy-lactic use of antibiotics.

Type Ⅰ incision surgeryPerioperative periodProphylactic use of antibioticReasonable use of anti-bioticProphylactic use of antibiotics during perioperative periodHospital grade

曾凌、史庆丰、高晓东、胡必杰、沈燕

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南昌大学第一附属医院感染控制处,江西南昌 330006

复旦大学附属中山医院感染管理科,上海 200032

复旦大学附属中山医院感染病科,上海 200032

Ⅰ类手术切口 围术期 预防用药 合理用药 围术期抗菌药物预防使 用医院类别

上海申康医院发展中心市级医院临床科技创新基金资助项目上海申康医院发展中心市级医院诊疗技术推广及优化管理基金资助项目

SHDC22021315SHDC22022215

2024

10.11816/cn.ni.2024-238628

中华医院感染学杂志
中华预防医学会 中国人民解放军总医院

中华医院感染学杂志

CSTPCD北大核心
影响因子：1.885
ISSN：1005-4529
年,卷(期)：2024.34(5)
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