| Background:Antimicrobial drugs are a class of bacteria to inhibit or kill the drug. As one of the most important achievements of the twentieth century,the birth of antimicrobial drugs for human brings a great gospel,and its application in surgery ensures effective patient safety,reduce postoperative infection, improve the cure rate. But now,the irrational use of antimicrobial drugs has become a global public health problem. Rational use of antimicrobial drugs to control resistant bacteria is imminent. In2011,China’s former Ministry of Health issued a "national clinical use of antibiotics in special rectification program of activities ",requiring intervention for irrational usage of surgical prophylactic antimicrobial in hospitals nationwide.As a member of the medical team,clinical pharmacists from the domestic part of the hospitals have served perioperative monitorion and intervention in irrational rational use of antimicrobial drugs phenomenon duties currently.To evaluate the clinical pharmacy intervention in current clinical pharmacists and to promote the implementation of perioperative antimicrobial effects of the rational use of the situation, we especially carried out this study,to further improve the level of clinical rational use of antimicrobial drugs.Objective:We evaluated antimicrobial resistance arising by application of perioperative prophylactic antimicrobial drugs using clinical pharmacy intervention in both clean and contaminated operation from pilot hospitals with the clinical pharmacists system,and analyzed its shortcomings for providing policy advice and management strategies in order to improve perioperative prophylactic use of antibiotics reasonable level.Methods:We used the on-site investigation to take a typical sampling and get the information and data of antimicrobial drug use from hospitalized patients.,and the results of the three hospitals with clinical pharmacist intervention system pilot implementing clinical pharmacy clinical pharmacists was conducted with a qualitative and quantitative evaluation.836cases with clinical pharmacy intervention after surgery accepted in2011was treated as an intervention group,879cases without clinical pharmacy intervention after surgery accepted in2010was treated as the non-intervention group.Reasonableness of the conditions of antimicrobial drug use before and after the intervention,DDDs and antimicrobial drug costs was compaired..Results:After the implementation of clinical pharmacy interventions,the reasonable rate of antimicrobial drug use has increased from16.3%to52.59%for the clean operation (P<0.01), the reasonable rate of antimicrobial drug use has increased from16.3%to52.59%for the clean contaminated operation (P<0.01).The types of antimicrobial drug used has been decreased from31kinds to19kinds as well as an increasing use of second-generation cephalosporin, and a reducing use of three generations of cephalosporins or above (P<0.05). With the decline of the second and third line antimicrobial drug,the costs has also made a significant decrease (P<0.05).Conclusion:The clinical pharmacy intervention can effectively improve the rationality use of perioperative antimicrobial agents in both clean and clean contaminated, alleviate and improve the situation of irrational use of antimicrobial agents, and thus to a certain extent, avoiding the occurrence of bacterial resistance. For some irrational phenomenon of antimicrobial agents which still exists, we need further improvement of clinical pharmacy intervention program and we should continue to increase guidance to physicians prescribing under hospital regulatory and the education from clinical pharmacists on how to use physicians antimicrobial drugs. Therefore, we can further reducing the generation of resistant bacteria,reducing economic burden on patients as well as improving the level of rational drug use... |
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