Analysis Of Perioperative Use Of Antibacterials On 436 Patients In The Orthopedics Department Of In Handan Central Hospital During The Past 4 Years

Objective: Antimicrobials have a vital role in the treatment of infectious diseases.In recent some years,because of the antibiotics abuse,the enhancing of pathogenic bacteria on drug resistance and the increasing of drug-resistant bacteria species,the prevention and cure of infectious disease become more difficult.Among various kinds of common diseases,orthopedic diseases are very common,unreasonable application of orthopaedic antimicrobials unreasonable application result in more adverse reactions,drug resistance increase,drug-resistant strains increase,patients infection and cardiovascular disease,but also easy to cause the digestive system complications,which resulting in treatment failure.So the analysis of the orthopaedic surgery infection risk factor,understand of the status of the orthopaedic antimicrobial use is great significance in the clinical applications.Our hospital is a comprehensive 3armour hospital,the numbers of orthopaedic patients,infection type and antibiotic usage is much,the usage of antibacterial,drug-resistant bacteria resistance,the bacteria distribution of survey has representative significance.Data in this research comes from handan city central hospital of electronic information management system provided by the inpatient pharmacy from May 2014 to May 2016 in the hospital orthopedic ward patients effective drug use statistical data。analysis and study fron the risk factors of infection in orthopaedic surgery,it can concluded the most important factor of infection,then take effective measures to avoid the occurrence of nosocomial infection timely.On the other hand research and analysis the orthopaedic inpatients treatment in the process of the usage of anti-infective drugs,can evaluate the reasonable application of anti-infection drugs,analyze unreasonable drug use situation,and make corresponding measures,to ensure the rational use ofdrugs.Methods: The first part,the method of retrospective survey,collecting cases,hospital patients clinical data records,sorting,summary,the system input and check one by one example.After verification,will collect the questionnaire after each project,in turn,coding,the use of EXCEL software to establish the database and data entry,the system using SPSS16.0 statistical software for statistical processing analysis,counting data powerusageeffectiveness,composition ratios describe said.This study will influence hospital infection factors as independent variables,and whether the hospital infection as dependent variable,the questionnaire related factors for assignment.By chi-square analysis(including calibration chi-square test)or Fisher exact probability method is caused by the exposure factors on different levels of incidence of a disease,by double side inspection method,with alpha = 0.05 as the inspection level,P < 0.05 for statistical significance.Significance test first to adopt chi-square test,single factor analysis and single factor analysis with statistical significance and clinical professional think related factors on the regressive method of multi-factor logistic stepwise regression analysis,it is concluded that the orthopaedic patients in hospital infection associated risk factors.The second part,in the analysis of treatment in hospital infection patients and preventive application of antimicrobial agents,the article retrospective investigation of nosocomial infection in the aftermath of the orthopaedic surgery patients.By transforming the original data entry Epidata collected,establish a database;Input content after review and correct the import in the Excel and SPSS statistical analysis;Select the appropriate indicators and statistical analysis methods described,use the way such as mean,maximum minimum statistical description for measurement data;Using frequency,rate or forming than counting data statistical description,chi-square test is used to compare rates between groups;With unconditional Logistic regression analysis the influence factor of the inappropriate use of antimicrobial agents,comprehensive analysis and finishing condition and trend of antimicrobialapplication,through relevant guiding principles for judging the rationality of drug use.Results: Orthopaedic hospital older patients,patients with internal primary basic diseases,treatment due to the hospital,stay in bed for a long time,in the process of fracture damage and other surgical trauma patients with invasive operation caused by the body resistance decline,is especially elderly orthopaedic inpatients in orthopaedic patients the main reason for the high incidence of hospital infection.Don’t rational drug use,prophylactic use of antimicrobial agents unreasonable main show is selected to high grade,accounted for 69.67%,followed by the dosage is too large,accounting for62.33%;In the therapeutic use of antimicrobial agents,no indications frequent treatment with medication too long for the main forms for the rational use of drugs.Conclusion: According to the characteristics of the hospitalized patients with orthopedic medical personnel should pay great attention to,according to the characteristics of the etiology and the quantitative positive and effective preventive measures;Determined by analysis of risk factors in the process of treatment,in a timely manner targeted to carry out the measures to prevent infection;Through strengthen the nursing measures such as health care workers,effectively reduce the hospital infection rate.Problems of unreasonable drug use according to the present,the hospital should continue to strengthen education and business training,make the clinicians to master the basic knowledge of the rational use of antimicrobial agents,reasonable and proper use of antibacterial drugs;Work pay more attention to the status of clinical pharmacists in the rational use of drugs,to strengthen the guidance of clinical pharmacy.In addition in order to improve the business level of clinical physicians and clinical pharmacists,hospital should organize regular clinical pharmacy experts for the physician about rational drug use of new knowledge,new progress in academic report,update the idea of rational drug use,improve the level of knowledge,make the role of pharmacists in specification rational drug use into full play.