Rational Utilization Of Antibiotics For The Perioperative Patients Of â…  And â…¡ Types Incisions: An Interventional Study

Objective:To explore a set of scientific evaluation and intervention methods on perioperative period which fits for BinHai area's situation, and to promote the development of rational use of perioperative antimicrobial agents.Methods:Some of the indicators was used in this study to examine the feasibility and effectiveness. These indicators include the proportion of reasonable and unreasonable application of antibiotics, days of hospitalization, days of hospitalization after surgery, hospital fees, the proportion of reasonable application of antibiotics in different surgery incision types, costs of antibiotics and nosocomial infection rates. After the intervention on using antibiotics, the costs of antibacterial drugs were decreased, the proportion of unreasonable application of antibacterial drugs was decreased, hospital days and hospital fees were reduced, nosocomial infection rates was unchanged or decreased. The indicators above in non-interventional group were difference significantly comparing with interventional group. Four hundreds discharged cases were selected from the largest "Rank-III B"general hospital in BinHai area in this investigation. Two hundreds discharged cases in each groups, interventional group and non-interventional group, were investigated followed by the guideline, Basic Principle of Using Antibiotics in Clinic. According to operative types each group was divided into four subsets, glandula thyreoidea operation, laparoscopic cholecystectomy, abdominal hysterectomy and hysteromyoma annexa operation. Patient's age, sex, the basis of health status, other company diseases, the expenses in hospital, hospital days, postoperative hospital days and operative incision types, antibiotics variety and expense were analied. Rationality of medication, infection, combination of antibiotics and adverse drug reaction were recorded.Results:Reasonable using antibiotics was to be reached by reinforcing the management of prophylactic medication during perioperation, formulating practicable regulations, supervising the feedback results, and conducting intervenient measures. The average hospital days in interventional group was reduced remarkably (P<0.05). The average pre-operational hospitalized days in interventional group and non-interventional group was no significant difference. Average hospitalization expenses and charges for medicine were no significant difference. The average antibiotics expenses between two groups were remarkable significantly (P<0.01). The average expenses of medicines and antibiotics in the interventional group were both lower than those in non- interventional one. Particularly, the average expenses of antibiotics and the expenses gynecological operations were lower in interventional group (P<0.01). The ratio of the rational utilization of antibiotics in the interventional group was increased. The ratio of combination used of antibiotics between two groups was significantly different. The incidence of surgical wound infections in two groups had no statistically difference (P>0.05).Conclusions:Intervention in this study decreased un-reasonable rate of using antibiotics, promoted more effective utilization of antibiotics, decreased hospitalized days and costs on antibiotics. This interventional measurements were safe, effective, economic and feasible. Moreover, these intervention methods will provide an effecfive and feasible model for reducing the expenses in the single disease. It will be beneficial to patients, hospitals and our country.