| BACKGROUND The clinical application of antimicrobial drugs is incomparable to the promotion of modern medicine.However,things have two sides,and the subsequent abuse of antimicrobial drugs,inevitably caused a lot of harm.In October 2011,the former Ministry of Health of China said that the use rate of antibiotics in domestic patients accounted for about 70%,which is twice as high as that in Europe and the United States,but strictly in accordance with the standards of diagnosis and treatment,the real need for the use of antibiotics probability,but not more than 20%.Irrational use of antibiotics in surgical clinic,especially in type I incision surgery,is a particularly common situation.Since 2011,the Ministry of Health of China has carried out special rectification activities for the rational use of antibiotics throughout the country,and formulated relevant documents to consolidate and enhance the special rectification activities continuously for several years.Effectiveness,adhere to improve the use of antimicrobial systems,standards,in view of the key difficulties to increase efforts to improve its management of clinical application.OBJECTIVE The purpose of this study was to study the use of antibiotics in the prevention of type I incision surgery in a grade three general hospital in Hefei,Anhui Province,and to compare and analyze the effect of comprehensive measures such as multi sector supervision of rational drug use on the use of antibiotics in the prevention of type I incision surgery,so as to promote the use of antibiotics in the prevention of type I incision surgery.The method of rationality provides the basis for sustainable improvement.METHODS According to the document spirit of the higher health department,the intervening time of the standardized management of antibiotics and the time of implementing the information system to manage the use of antibiotics,6247 cases of type I incision surgery in a grade three general hospital of Hefei,Anhui Province,from April 2013 to March 2015,were included in the non-intervention group.From January to March 2017,a total of 7622 cases of type I incision surgery were included in the intervention group.The intervention was carried out by multi sector supervision of rational drug use,and the use of prophylactic antibiotics was compared between the two groups.RESULTS After intervention,the prophylactic use rate of antibiotics decreased from 39.09%(2442/6247)to 24.62%(1877/7622)(P < 0.05),and the use rate of non-restricted antibiotics cefuroxime and cefazolin increased from 23.21%(567/2442)to 84.71%(1590/1877),and the proportions of type I incision surgerys involved in rational drug use check list decreased from 4.7%(295/6247)to 1.1%(81/7622)(P<0.05).The prophylactic use rate of six kinds of antimicrobial agents,such as thyroid surgery,which were not used to prevent the use of antimicrobial agents in principle,decreased from 23.15%(122/527)to 11.34%(70/617),and the rational choice rate of antimicrobial agents rose from 74.76% to 97.18%.The irrational rate of antimicrobial use timing from 1.03% to 0.69%,the unsuitable duration of antimicrobial prophylaxis decreased from 2.15% to 1.55%,the irrational rate of antimicrobial prophylaxis decreased from 2.11% to 0.75%,the irrational rate of replacing antimicrobial prophylaxis decreased from 0.5% to 0.11%,the irrational rate of combined antimicrobial prophylaxis decreased from 0.33% to 0,and the infection rate of surgical incision decreased from 0.33%.08%(2/2442)decreased to 0.CONCLUSION The comprehensive intervention method of multi sector supervision of rational drug use has obvious effect,which significantly improves the rationality of antimicrobial prophylaxis in type I incision surgery. |
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