| Objective:1. To find the existed problems, analyze the reason and discuss the severity of antimicrobial abuse by investigating of the status of antimicrobial use for prophylaxis in perioperative patients in a 3 A Grade Hospital. To feed them back to the surgical doctors and the supervisors in order to enhance their awareness of the rational use of antibiotics.2. To carry out contrast studies of intervention. To study the influence on the incidence of postoperative infection, the charge (including the charge of antibiotics.) and the incidence of adverse drug reaction by the intervention; The results can provide the reference to the clinic and the supervisors.3. To study the emphasis of the intervention. To estimate and ensure the effectiveness of the intervention in order to the rational use of drug.Methods:1. Operation Typeâ… Incision include thyroid gland, mammary glands and laparoscopic cholecystectomy. Operation Type II Incision include uterine-incision delivery. To make the investigation and the valuation of imicrobial use for prophylaxis in perioperative patients from the policies of Ministry of Public Health. To find all the cases of the above-mentioned operations of this hospital during January to September in 2009. There are 1876 cases consistent with requirement. To investigate, analyze and value these cases in standardization. The data is written by excel and analyzed by spss11.5.2. To make the contrast studies of intervention in the operation of thyroid gland, mammary glands and laparoscopic cholecystectomy. The working days from July to September in 2009 were separated into adequate and inadequate group randomly. The project of the adequate group is planed, and the other is not.. The quantity of each group is 20. To access the difference of the incidence of postoperative infection, hospital day and the charge between two groups. The measurement material use the t examination, counts the material to use the X~2 examination. Results: 1. 1876 patients received antibiotic treatment. The rate of antibiotics prophylaxis was 100.0%. The irrational use of antibacterials is 679 cases (36.2%). 145 patients (7.7%) received special use of antibacterials, and 339 patients(18.1%) received restrictive use of antibacterials. The rate of antibiotics combination was 1.8%;14 patients(0.7%) didn't received antibiotics within 2 hours before operation. the average duration of antibiotics usage was 2.5 days, and 1228 cases(65.5%) used the antibacterials for long time. 120 cases (6.4%) received high dose.2. The incidence of postoperative infection and adverse drug reaction between adequate and inadequate group were all zero. There was no statistical significance(p>0.05). There was significant difference(p<0.05) on hospital day and the charge between two groups. There was significant difference(p<0.05) on time of antibiotics usage and the kinds of antibiotic used in thyroid gland operation. The difference of the kinds of antibiotic used in the operation of mammary glands and laparoscopic cholecystectomy was significant difference(p<0.01).Conclusions: There were many problems existed in the antibiotics usage of this hospital. The major problems were excessive prophylaxis in surgical system (especial in Typeâ… Incision include thyroid gland, mammary glands), high rate of irrational antibiotics usage, long duration of antibiotics prophylaxis and incorrect dose of the antibacterials. These problems were stood out in the operation of uterine-incision delivery . It is urgent to take measures to control the abuse of antibiotics and enhance the rate of rational usage. Only in this way,the bacterial resistance and high medical cost should be reduced,and achieve rational use of antibaeterial.
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