Antibiotics Use in Perioperative Period of Hernioplasty by Intervention-control Study_West China Medical Journal

Authors：

 ZHENGGao-feng ¹ ,  RENXiao-bing ² , ZHANGYu-hong ¹ , YUEXiao-hui ¹ , HUANGMeng-ya ¹ , GOUChao-hui ¹

1. Department of Pharmacy, People's Hospital of Jianyang City, Jianyang, Sichuan 641400, P. R. China;
2. Department of Medical Quality Control, People's Hospital of Jianyang City, Jianyang, Sichuan 641400, P. R. China;

Corresponding?author：

RENXiao-bing, Email: 270992325@qq.com

Keywords：

Hernioplasty; Perioperative period; Antibiotics; Intervention-control study

DOI：

10.7507/1002-0179.20140133

Video：

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Objective To evaluate rational use of antibiotics for hernioplasty in perioperative period by intervention-control study in order to provide a foundation for the clinical antibiotic use and management. Methods The data of the preventive use of antibiotics for hernia patients from January to October, 2010 in perioperative period were collected and compared. Interventions on patients from January to October, 2011 were carried out. Results In the intervention group, the first three antibiotics used were changed from azlocillin, mezlocillin and aztreonam before intervention to cefazolin, clindamycin and azlocillin after intervention. Before intervention, antibiotics were first used after surgery for surgical prophylaxis, while after intervention, antibiotics were first used within 30 minutes before surgery or at the start of induction of anesthesia. The preventive medication time decreased from (3.50±2.07) days to (0.88±1.07) days (t'=14.601, P=0.000), the hospitalization days of post-surgery decreased from (5.17±1.90) days to (3.77±1.61) days (t'=7.313, P=0.000), the cost of antibiotics decreased from (342.39±415.50) yuan to (54.08±80.83) yuan (t'=8.831, P=0.000), the percentage of the cost of antibiotics in expenses for medicine declined from (47.53±25.51)% to (12.49±13.46)% (t'=15.776, P=0.000), and the percentage of the cost of antibiotics in hospitalization expenses declined from (6.59±5.49)% to (1.07±1.35)% (t'=12.662, P=0.000). The difference in inappropriate use of antibiotic drugs before and after prevention, such as choice of preventive drugs, preoperative medication occasion, course of postoperative medication and no indication of drug combination, had statistical significances (P<0.05). Conclusion The intervention-control study shows that the rational use of antibiotics for hernioplasty in perioperative period can be improved, and the average hospitalization days and the cost of antibiotics can be reduced by intervention.

Citation： ZHENGGao-feng, RENXiao-bing, ZHANGYu-hong, YUEXiao-hui, HUANGMeng-ya, GOUChao-hui. Antibiotics Use in Perioperative Period of Hernioplasty by Intervention-control Study. West China Medical Journal, 2014, 29(3): 445-448. doi: 10.7507/1002-0179.20140133 Copy

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14.	梁兆克, 孫林. 生物補片植入腹股溝疝無張力疝修補后預防性應用抗生素的薈萃分析[J]. 中國組織工程研究與臨床康復, 2011, 15(47):8869-8872.
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1. 李寶珍, 平寶華, 關仙花. 疝修補術患者預防使用抗菌藥物調查分析[J]. 中國感染與化療雜志, 2009, 9(4):318-320.
2. 張麗, 翟所迪. Ⅰ類切口圍手術期抗菌藥物預防應用的調查[J]. 中國臨床藥理學雜志, 2009, 25(1):70-72.
3. 肖永紅, 王進, 朱燕, 等. Mohnarin 2008年度全國細菌耐藥監測[J]. 中華醫院感染學雜志, 2010, 20(16):2377-2383.
4. 中國人民共和國衛生部. 衛生部辦公廳關于抗菌藥物臨床應用管理有關問題的通知[EB/OL]. (2009-03-25)[2013-10-22]. http://www.moh.gov.cn/mohbgt/s9508/200903/39723.shtml.
5. 中華人民共和國衛生部, 國家中醫藥管理局, 總后衛生部. 抗菌藥物臨床應用指導原則[EB/OL]. (2004-08-19)[2013-10-22]. http://www.sfda.gov.cn/wyf04285/2004285.zip.
6. 傅小芳, 張繼東, 駱華杰. 擇期腹股溝疝修補術抗菌藥物預防使用對手術部位感染的影響[J]. 中華醫院感染學雜志, 2012, 22(12):2651-2652.
7. 中華人民共和國衛生部醫政司, 衛生部合理用藥專家委員會. 《抗菌藥物臨床應用管理辦法》釋義和抗菌藥物臨床應用培訓教材[M]. 北京:人民衛生出版社, 2012:546.
8. 植路君, 張世輝, 李月華. 圍手術期應用抗生素狀況分析[J]. 華西醫學, 2011, 26(4):587-589.
9. 應用抗菌藥物防治外科感染的指導意見撰寫協作組. 應用抗菌藥物防治外科感染的指導意見(草案)Ⅱ[J]. 中華外科雜志, 2003, 41(7):552.
10. 孫言才, 史天陸, 姜玲等. Ⅰ類切口手術圍手術期預防用抗菌藥物干預對照研究[J]. 中華醫院感染學雜志, 2010, 20(10):1447-1450.
11. 王仲書, 蘭文英. 圍手術期預防性應用抗菌藥物的調查與分析[J]. 華西醫學, 2010, 25(12):2241-2243.
12. 王敏, 朱惠新, 李希平. 外科圍手術期患者預防性應用抗菌藥物分析[J]. 華西醫學, 2010, 25(12):2237-2240.
13. 趙晨辰, 梁存河, 譚嗣偉, 等. 無張力疝修補術預防性應用抗生素研究進展[J]. 中華疝和腹壁外科雜志·電子版, 2012, 6(3):814-816.
14. 梁兆克, 孫林. 生物補片植入腹股溝疝無張力疝修補后預防性應用抗生素的薈萃分析[J]. 中國組織工程研究與臨床康復, 2011, 15(47):8869-8872.
15. 中華人民共和國衛生部. 衛生部辦公廳關于繼續深入開展全國抗菌藥物臨床應用專項整治活動的通知[EB/OL]. (2012-03-06)[2013-10-22]. http://www.moh.gov.cn/mohyzs/s3586/201203/54251.shtml.

West China Medical Journal

Antibiotics Use in Perioperative Period of Hernioplasty by Intervention-control Study

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