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, 孙林. 生物补片植入腹股沟疝无张力疝修补后预防性应用抗生素的荟萃分析[J]. 中国组织工程研究与临床康复, 2011, 15(47):8869-8872.
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1. 李宝珍, 平宝华, 关仙花. 疝修补术患者预防使用抗菌药物调查分析[J]. 中国感染与化疗杂志, 2009, 9(4):318-320.
2. 张丽, 翟所迪. Ⅰ类切口围手术期抗菌药物预防应用的调查[J]. 中国临床药理学杂志, 2009, 25(1):70-72.
3. 肖永红, 王进, 朱燕, 等. Mohnarin 2008年度全国细菌耐药监测[J]. 中华医院感染学杂志, 2010, 20(16):2377-2383.
4. 中国人民共和国卫生部. 卫生部办公厅关于抗菌药物临床应用管理有关问题的通知[EB/OL]. (2009-03-25)[2013-10-22]. http://www.moh.gov.cn/mohbgt/s9508/200903/39723.shtml.
5. 中华人民共和国卫生部, 国家中医药管理局, 总后卫生部. 抗菌药物临床应用指导原则[EB/OL]. (2004-08-19)[2013-10-22]. http://www.sfda.gov.cn/wyf04285/2004285.zip.
6. 傅小芳, 张继东, 骆华杰. 择期腹股沟疝修补术抗菌药物预防使用对手术部位感染的影响[J]. 中华医院感染学杂志, 2012, 22(12):2651-2652.
7. 中华人民共和国卫生部医政司, 卫生部合理用药专家委员会. 《抗菌药物临床应用管理办法》释义和抗菌药物临床应用培训教材[M]. 北京:人民卫生出版社, 2012:546.
8. 植路君, 张世辉, 李月华. 围手术期应用抗生素状况分析[J]. 华西医学, 2011, 26(4):587-589.
9. 应用抗菌药物防治外科感染的指导意见撰写协作组. 应用抗菌药物防治外科感染的指导意见(草案)Ⅱ[J]. 中华外科杂志, 2003, 41(7):552.
10. 孙言才, 史天陆, 姜玲等. Ⅰ类切口手术围手术期预防用抗菌药物干预对照研究[J]. 中华医院感染学杂志, 2010, 20(10):1447-1450.
11. 王仲书, 兰文英. 围手术期预防性应用抗菌药物的调查与分析[J]. 华西医学, 2010, 25(12):2241-2243.
12. 王敏, 朱惠新, 李希平. 外科围手术期患者预防性应用抗菌药物分析[J]. 华西医学, 2010, 25(12):2237-2240.
13. 赵晨辰, 梁存河, 谭嗣伟, 等. 无张力疝修补术预防性应用抗生素研究进展[J]. 中华疝和腹壁外科杂志·电子版, 2012, 6(3):814-816.
14. 梁兆克, 孙林. 生物补片植入腹股沟疝无张力疝修补后预防性应用抗生素的荟萃分析[J]. 中国组织工程研究与临床康复, 2011, 15(47):8869-8872.
15. 中华人民共和国卫生部. 卫生部办公厅关于继续深入开展全国抗菌药物临床应用专项整治活动的通知[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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