Comparative Analysis Of Prophylactic Use Of Antibacterial Drugs During Perioperative Period In General Surgery At A Grade 2 A Hospital In Weihai

Objective: The goal of this research was to analyze the rationality of preventive applications of antimicrobial drugs in perioperative period before and after pharmacist interventions in general surgery department of a grade 2 A hospital in Weihai city,and to verify the benefits of clinical pharmacist interventions and rectification of antibacterial drugs for guidance of prophylactic use of antimicrobial drugs in clinical perioperative period.Methods: The cases of perioperative patients before(320,January to June in 2015)and after(345,January to June in 2016)pharmacists intervention were collected in general surgery department of a grade 2 A hospital in Weihai city.Then,the factors that affect normal perioperative treatment were eliminated.Analysis of perioperative prophylactic usage of antimicrobial drugs and the incidence of surgical site infection,postoperative incision healing,hospitalization expenses was conducted referring to the medication indications,drug selection,preparation time,usage,dosage,combined usage and ways and courses.The effects of the latest version of The Clinical Application of Antibacterial Drugs Guiding Principles and clinical pharmacists intervention on clinical medication,the incidence of surgical site infection and the hospitalization costs were observed and compared.Results:1.Irrational drugs used before the intervention were much more common than that after intervention,especially in Ⅰ type of incision surgery.While,the irrational use after the intervention was closely associated with the risk of infection.Over all irrational drug indications were improved significantly after the intervention(p<0.01).2.The course of patient’s medical treatment was significantly shortened after the intervention(p<0.01).3.The most drugs used before the intervention were cephalosporin(49%)and quinolone(29%);While,the most drugs used after the intervention were cephalosporin(79%)and clindamycin(13%),which are considered as the best choices of antimicrobial drugs.4.The rationality of drug delivery timing was improved significantly after the intervention(p<0.01).5.There were 3 cases that switching the antimicrobial agents without medication indications before the intervention.However,switching of antibacterial drugs was based on the results of bacterial culture after the intervention.6.The unreasonable drug combination was eliminated after the intervention(p<0.05).7.Bacteria examination rate of specimens in the prophylactic usage of antimicrobial agents increased from 7.81% to 38.55%(p<0.05),the incidence of SSI reduced from 3.12% to 0.87%(p<0.05),and patient’s hospitalized time shortened from 14.89±1.25 days to 12.14±1.38 days(p<0.05).8.The average hospitalization expenses,the average expenses of drug and the average antimicrobial agents were dramatically dropped after the intervention(p<0.05).Conclusion:1.Under the guidance of The Clinical Application of Antibacterial Drugs Guiding Principles(2015),the hospital established a series of related system sand policies,and achieved better out comes with the clinical pharmacists’ implementation and clinicians’ cooperation.2.The rationality of perioperative prophylactic use of antimicrobial agents in terms of medication indications,drug selection,drug treatment,usage,dosage,and the rationality of the specimen sampling rate and etc.improved significantly,which reduced the incidence of postoperative infection,hospitalization time and cost.3.This research provids evidence for the hospital and other primary medical institutions to establish and improve the related systems and policies of rational antibacterial drug use.This research also explores a new working mode for clinical pharmacists to serve patients and clinical physicians effevtively and efficiently.