Prevalence Study Of Surgical Antibiotic Usage And Case-control Study On Risk Factors Of Postoperative Infection

Objectives:To investigate the status of surgical antibiotic usage, and assess the risk factors of postoperative infection.To find the existed problems and feed them back to the surgical doctors and the supervisors in order to enhance their awareness of the rational use of antibiotics.Methods:1.The questionnaire was designed to meet the study goals.The study surveyed 3221 cases underwent operations from Jan. to Mar. in 2006, and analyze the collected data by SPSS 13.0.2.All the cases were separated into adequate and inadequate group according to the criteria, and access the differnce of surgical wound infections and hospital acquired infections between the two groups. Use the Chi-square test to analyze the influence of antibiotic combination, kinds of antibiotics, duration of antibiotic usage, the opportunity of antibiotics prophylaxis preoperative, antibiotics used during operation and the grade of antibiotics on the nosocomial infections . 3. Use the Spearman correlation method to analyze the relationship between the frequency of nosocomial infections and the antibiotic combination,duration of antibiotics usage, the kinds and the grade of antibiotics used. 4.Chose 88 postoperative infected patients as case group, and at the same time ,chose another 88 uninfected patients as control group.The two groups were matched in age, gender,surgical department and operation type.To find the risk factors closed to nosocomial infection.Results:1. 3217 patients received antibiotic treatment,the rate of antibiotic usage was 99.88%.The rate of antibiotics prophylaxis was 94.4%.54.5% patients received the third-class antibiotics; the rate of antibiotics combination was 39.1%;the average duration of antibiotics usage was 8.12 days,and the duration of postoperation prophylaxis was 7.06 days;444 patients received antibiotics within 2 hours before operation. When the duration of operations passed 3 hours, 21.72% of the patients were given antibiotic during the operations.2.There was significant difference on nosocomial infection between the two groups(P<0.05).For those who received adequate antibiotics, the percentage of nosocomial infection was 1.46%compared with the group who received inadequate prophylaxis in which the percentage of nosocomial infection was 2.93%.The difference of surgical wound infections between the two groups was also significant (P<0.05).3.There were positive correlations between the frequency of nosocomial infections and the antibiotics combination, the kinds of antibiotic used, the antibiotic grade and the duration of antibiotics usage. 4.Multiple-variation Logistic Regression Analysis indicated that the related factors of postoperative infection included the kinds and duration of antibiotic prophylaxis, the time of preoperative antibiotic prophylaxis.Conclusions: There were many problems existed in the antibiotics usage.The major problems were excessive prophylaxis in surgical system,long duration of antibiotics prophylaxis,high rate of third-class antibiotics usage, incorrect time of antibiotic prophylaxis before operation and low percentage of antibiotics usage during operation.The abuse of antibiotic can intensify the risk of postoperation nosocomial infections, and result in the increasement of multi-drug resistant germs.It is urgent to take measures to control the abuse of antibiotics and enhance the rate of rational usage.