A retrospective study on the application of antimicrobial agents in patients undergoing day surgery_West China Medical Journal

Authors：

HUANG Xiaoxuan ^1,2 , XIE Xinxiu ^1,2 , LIU Weidong ² ,  MO Yang ^1,2

1. Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P. R. China;
2. Day Surgery Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P. R. China;

Corresponding?author：

MO Yang, Email: moyang1980my@csu.edu.cn

Keywords：

Day surgery; Antimicrobial agents; Rational drug use; Surgical site infection

DOI：

10.7507/1002-0179.202012345

Video：

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Objective To analyze the current situation of antimicrobial agents using in day surgery patients to guide the rational use of antimicrobial agents in day surgery.Methods The day surgery performed in Day Surgery Center of Xiangya Hospital of Central South University from June 2016 to September 2017 was selected. We retrospectively collected and analyzed patients’ hospitalization data and return visit data, statistically analyzed their use of antimicrobial agents, explored whether there was an unreasonable phenomenon in the use of antimicrobial agents, and analyzed the reasons.Results There were 4 054 surgeries included in this study, and 1 293 patients using antimicrobial agents, the use rate of antimicrobial agents in day surgery patients reached 31.89%. Aseptic, clean-contaminated, contaminated and dirty surgery accounted for 12.22%, 65.20%, 7.27%, and 15.31% separately. Whether the application of antimicrobial agents in aseptic surgery patients had no effect on the outcome of the incision (P=0.073). The most common type of antimicrobial agents used by patients are cephalosporins (57.50%), mainly used as single drugs (97.91%) and mostly oral used in patients’ home. Most of the sources of antimicrobial agents were purchased by patients after they were discharged from the hospital (65.43%). The antimicrobial agents more used by Stemmatological Department (23.98%), Ear/Nose/Throat Department (22.58%) and Obstetrics and Gynecology Department (22.51%). The average used time of antimicrobial agents was (5.37±1.86) days, and 7.42% of patients still had surgical site infections after the use of prophylactic antimicrobial agents, most of them from General Surgery Department.Conclusions The unreasonable phenomena in the use of antimicrobial agents in patients with day surgery include: a high proportion of preventive medications for clean-contamination surgery, a high level of initial medication, and most patients take oral medications at home and lack of guidance, and long medication time. There is an urgent need for scientific guidance on the use of antimicrobial agents for patients undergoing day surgery.

Citation： HUANG Xiaoxuan, XIE Xinxiu, LIU Weidong, MO Yang. A retrospective study on the application of antimicrobial agents in patients undergoing day surgery. West China Medical Journal, 2021, 36(2): 205-210. doi: 10.7507/1002-0179.202012345 Copy

1.	Ploegmakers IB, Olde Damink SW, Breukink SO. Alternatives to antibiotics for prevention of surgical infection. Br J Surg, 2017, 104(2): e24-e33.
2.	國家衛生計劃生育委員會. 遏制細菌耐藥國家行動計劃(2016-2020年). 藥物不良反應雜志, 2016, 18(5): 398-400.
3.	盧蕊, 周鳳瑤, 何鮮桂. 眼科日間手術預防性使用抗菌藥物回顧性研究. 中華醫院感染學雜志, 2010, 20(17): 2657-2658.
4.	楊文賓, 蔣悅赟, 李春潔, 等. 口腔日間手術的質量安全評價與管理//中華口腔醫學會口腔醫療服務分會. 2019年中華口腔醫學會口腔醫療服務分會第十三次全國口腔醫院管理學術會議論文匯編. 廣州: 中華口腔醫學會口腔醫療服務分會, 2019: 6.
5.	白雪, 馬洪升, 羅利. 中外日間手術發展對比研究及展望. 中國醫院管理, 2014, 34(5): 35-37.
6.	周雅靚. 預防性抗生素應用在日間腹腔鏡膽囊切除術手術部位感染的作用. 華西醫學, 2015, 30(8): 1494-1495.
7.	國家衛生計生委辦公廳, 國家中醫藥管理局辦公室, 解放軍總后勤部衛生部藥品器材局. 關于印發抗菌藥物臨床應用指導原則(2015年版)的通知. (2015-08-27)[2020-12-31]. http://www.nhc.gov.cn/yzygj/s3593/201508/c18e1014de6c45ed9f6f9d592b43db42.shtml.
8.	莫洋, 陳亞玲, 石峰華, 等. 開展品管圈活動降低日間手術爽約率的效果分析. 華西醫學, 2017, 32(4): 488-492.
9.	Jenkins K, Grady D, Wong J, et al. Post-operative recovery: day surgery patients’ preferences. Br J Anaesth, 2001, 86(2): 272-274.
10.	中華醫學會外科學分會外科感染與重癥醫學學組, 中國醫師協會外科醫師分會腸瘺外科醫師專業委員會. 中國手術部位感染預防指南. 中華胃腸外科雜志, 2019, 22(4): 301-314.
11.	李玉民. 外科手術部位感染(SSI)預防指南//亞洲外科學會, 中華醫學會外科學分會, 中華醫學會學術會務部. 2007中國外科周暨第16屆亞洲外科年會論文摘要集. 北京: 中華醫學會外科學分會, 2007: 101-102.
12.	李芳, 李雯, 袁晶, 等. 某綜合性教學醫院2019年細菌耐藥性分析. 華西醫學, 2020, 35(8): 905-911.
13.	Dafale NA, Semwal UP, Rajput RK, et al. Selection of appropriate analytical tools to determine the potency and bioactivity of antibiotics and antibiotic resistance. J Pharm Anal, 2016, 6(4): 207-213.
14.	Ianiro G, Tilg H, Gasbarrini A. Antibiotics as deep modulators of gut microbiota: between good and evil. Gut, 2016, 65(11): 1906-1915.
15.	劉永華, 祝洪珍, 牛俊奇. 清潔手術預防性應用抗菌藥物的調查分析. 中華醫院感染學雜志, 2006(8): 922-924.
16.	謝揚, 楊揚震, 黃永豪, 等. 骨科無菌手術應用抗生素防治感染的效果. 中華醫院感染學雜志, 2005, 15(7): 799-800.
17.	Chong JU, Lim JH, Kim JY, et al. The role of prophylactic antibiotics on surgical site infection in elective laparoscopic cholecystectomy. Korean J Hepatobiliary Pancreat Surg, 2015, 19(4): 188-193.
18.	汪超, 黃強, 林先盛, 等. 擇期腹腔鏡膽囊切除術預防性使用抗生素的作用meta分析. 中國普通外科雜志, 2015, 24(2): 258-264.
19.	胡燕, 白繼庚, 胡先明, 等. 我國抗生素濫用現狀、原因及對策探討. 中國社會醫學雜志, 2013, 30(2): 128-130.
20.	吳水發, 吳娜梅, 蔡藝峰, 等. 7 496例Ⅰ類切口手術圍術期預防性應用抗菌藥物調查與分析. 中國醫院用藥評價與分析, 2019, 19(1): 72-75.
21.	World Health Organization. Global guidelines for the prevention of surgical site infection. (2016-12-01)[2020-12-31]. https://apps.who.int/iris/handle/10665/250680.
22.	Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg, 2017, 152(8): 784-791.

1. Ploegmakers IB, Olde Damink SW, Breukink SO. Alternatives to antibiotics for prevention of surgical infection. Br J Surg, 2017, 104(2): e24-e33.
2. 國家衛生計劃生育委員會. 遏制細菌耐藥國家行動計劃(2016-2020年). 藥物不良反應雜志, 2016, 18(5): 398-400.
3. 盧蕊, 周鳳瑤, 何鮮桂. 眼科日間手術預防性使用抗菌藥物回顧性研究. 中華醫院感染學雜志, 2010, 20(17): 2657-2658.
4. 楊文賓, 蔣悅赟, 李春潔, 等. 口腔日間手術的質量安全評價與管理//中華口腔醫學會口腔醫療服務分會. 2019年中華口腔醫學會口腔醫療服務分會第十三次全國口腔醫院管理學術會議論文匯編. 廣州: 中華口腔醫學會口腔醫療服務分會, 2019: 6.
5. 白雪, 馬洪升, 羅利. 中外日間手術發展對比研究及展望. 中國醫院管理, 2014, 34(5): 35-37.
6. 周雅靚. 預防性抗生素應用在日間腹腔鏡膽囊切除術手術部位感染的作用. 華西醫學, 2015, 30(8): 1494-1495.
7. 國家衛生計生委辦公廳, 國家中醫藥管理局辦公室, 解放軍總后勤部衛生部藥品器材局. 關于印發抗菌藥物臨床應用指導原則(2015年版)的通知. (2015-08-27)[2020-12-31]. http://www.nhc.gov.cn/yzygj/s3593/201508/c18e1014de6c45ed9f6f9d592b43db42.shtml.
8. 莫洋, 陳亞玲, 石峰華, 等. 開展品管圈活動降低日間手術爽約率的效果分析. 華西醫學, 2017, 32(4): 488-492.
9. Jenkins K, Grady D, Wong J, et al. Post-operative recovery: day surgery patients’ preferences. Br J Anaesth, 2001, 86(2): 272-274.
10. 中華醫學會外科學分會外科感染與重癥醫學學組, 中國醫師協會外科醫師分會腸瘺外科醫師專業委員會. 中國手術部位感染預防指南. 中華胃腸外科雜志, 2019, 22(4): 301-314.
11. 李玉民. 外科手術部位感染(SSI)預防指南//亞洲外科學會, 中華醫學會外科學分會, 中華醫學會學術會務部. 2007中國外科周暨第16屆亞洲外科年會論文摘要集. 北京: 中華醫學會外科學分會, 2007: 101-102.
12. 李芳, 李雯, 袁晶, 等. 某綜合性教學醫院2019年細菌耐藥性分析. 華西醫學, 2020, 35(8): 905-911.
13. Dafale NA, Semwal UP, Rajput RK, et al. Selection of appropriate analytical tools to determine the potency and bioactivity of antibiotics and antibiotic resistance. J Pharm Anal, 2016, 6(4): 207-213.
14. Ianiro G, Tilg H, Gasbarrini A. Antibiotics as deep modulators of gut microbiota: between good and evil. Gut, 2016, 65(11): 1906-1915.
15. 劉永華, 祝洪珍, 牛俊奇. 清潔手術預防性應用抗菌藥物的調查分析. 中華醫院感染學雜志, 2006(8): 922-924.
16. 謝揚, 楊揚震, 黃永豪, 等. 骨科無菌手術應用抗生素防治感染的效果. 中華醫院感染學雜志, 2005, 15(7): 799-800.
17. Chong JU, Lim JH, Kim JY, et al. The role of prophylactic antibiotics on surgical site infection in elective laparoscopic cholecystectomy. Korean J Hepatobiliary Pancreat Surg, 2015, 19(4): 188-193.
18. 汪超, 黃強, 林先盛, 等. 擇期腹腔鏡膽囊切除術預防性使用抗生素的作用meta分析. 中國普通外科雜志, 2015, 24(2): 258-264.
19. 胡燕, 白繼庚, 胡先明, 等. 我國抗生素濫用現狀、原因及對策探討. 中國社會醫學雜志, 2013, 30(2): 128-130.
20. 吳水發, 吳娜梅, 蔡藝峰, 等. 7 496例Ⅰ類切口手術圍術期預防性應用抗菌藥物調查與分析. 中國醫院用藥評價與分析, 2019, 19(1): 72-75.
21. World Health Organization. Global guidelines for the prevention of surgical site infection. (2016-12-01)[2020-12-31]. https://apps.who.int/iris/handle/10665/250680.
22. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg, 2017, 152(8): 784-791.

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A retrospective study on the application of antimicrobial agents in patients undergoing day surgery

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