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

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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

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16.	谢扬, 杨扬震, 黄永豪, 等. 骨科无菌手术应用抗生素防治感染的效果. 中华医院感染学杂志, 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, 黄强, 林先盛, 等. 择期腹腔镜胆囊切除术预防性使用抗生素的作用meta分析. 中国普通外科杂志, 2015, 24(2): 258-264.
19.	胡燕, 白继庚, 胡先明, 等. 我国抗生素滥用现状、原因及对策探讨. 中国社会医学杂志, 2013, 30(2): 128-130.
20.	吴水发, 吴娜梅, 蔡艺峰, 等. 7 496例Ⅰ类切口手术围术期预防性应用抗菌药物调查与分析. 中国医院用药评价与分析, 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. 国家卫生计划生育委员会. 遏制细菌耐药国家行动计划(2016-2020年). 药物不良反应杂志, 2016, 18(5): 398-400.
3. 卢蕊, 周凤瑶, 何鲜桂. 眼科日间手术预防性使用抗菌药物回顾性研究. 中华医院感染学杂志, 2010, 20(17): 2657-2658.
4. 杨文宾, 蒋悦赟, 李春洁, 等. 口腔日间手术的质量安全评价与管理//中华口腔医学会口腔医疗服务分会. 2019年中华口腔医学会口腔医疗服务分会第十三次全国口腔医院管理学术会议论文汇编. 广州: 中华口腔医学会口腔医疗服务分会, 2019: 6.
5. 白雪, 马洪升, 罗利. 中外日间手术发展对比研究及展望. 中国医院管理, 2014, 34(5): 35-37.
6. 周雅靓. 预防性抗生素应用在日间腹腔镜胆囊切除术手术部位感染的作用. 华西医学, 2015, 30(8): 1494-1495.
7. 国家卫生计生委办公厅, 国家中医药管理局办公室, 解放军总后勤部卫生部药品器材局. 关于印发抗菌药物临床应用指导原则(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, 陈亚玲, 石峰华, 等. 开展品管圈活动降低日间手术爽约率的效果分析. 华西医学, 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. 中华医学会外科学分会外科感染与重症医学学组, 中国医师协会外科医师分会肠瘘外科医师专业委员会. 中国手术部位感染预防指南. 中华胃肠外科杂志, 2019, 22(4): 301-314.
11. 李玉民. 外科手术部位感染(SSI)预防指南//亚洲外科学会, 中华医学会外科学分会, 中华医学会学术会务部. 2007中国外科周暨第16届亚洲外科年会论文摘要集. 北京: 中华医学会外科学分会, 2007: 101-102.
12. 李芳, 李雯, 袁晶, 等. 某综合性教学医院2019年细菌耐药性分析. 华西医学, 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. 刘永华, 祝洪珍, 牛俊奇. 清洁手术预防性应用抗菌药物的调查分析. 中华医院感染学杂志, 2006(8): 922-924.
16. 谢扬, 杨扬震, 黄永豪, 等. 骨科无菌手术应用抗生素防治感染的效果. 中华医院感染学杂志, 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, 黄强, 林先盛, 等. 择期腹腔镜胆囊切除术预防性使用抗生素的作用meta分析. 中国普通外科杂志, 2015, 24(2): 258-264.
19. 胡燕, 白继庚, 胡先明, 等. 我国抗生素滥用现状、原因及对策探讨. 中国社会医学杂志, 2013, 30(2): 128-130.
20. 吴水发, 吴娜梅, 蔡艺峰, 等. 7 496例Ⅰ类切口手术围术期预防性应用抗菌药物调查与分析. 中国医院用药评价与分析, 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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