| Background:The rational use of antimicrobial drugs plays a very important role in controlling bacterial infection in patients. However, in our country, clinical surgery, especially the clean cut operation, the unreasonable preventive use of antibiotics is very common. The abuse of antibiotics not only enhances the bacterial drug resistance, but also increases the patient medical economic burden. It is an important subject how to solve the problem of antibiotic abuse in front of medical management.Prescription comment is a kind of drug regulatory model in the hospital management system. It provides scientific data for medical institutions management decision-making. It will be good for achieving the rational use of drugs and monitoring the preparation and management. Through the comprehensive statistical analysis on prescription in the process of clinical doctors, the management of medical institutions can fully grasp the prescription of medical institutions, in order to better manage medical personnel and reasonable use of drugs. It has been proved that the prescription comment on rational use of antimicrobial drugs in control is feasible.At present, there are no authority system and standard about the prescription comment in the domestic and international. The comment levels are also uneven in different hospital. There is a lack of related professionals in basic medical institutions. The comment ability and working experience is limited. At the consequence, prescription comment cannot fully reflect the existing problems in the prescription, which causes many problems appeared again and again and is difficult to be completely effective solution. Therefore, it is necessary to study and formulate an effective, practical prescription comment mode.We formulate the prescription comments in the hospital management system, set up the management mechanism on prescription comment. The prophylactic use of antimicrobial agents of the clean cut operation is carried out by prescription comment system. We investigate the feasibility and effect by comparing before and after the implementation. The main prescription comment indexes (the antibacterial drug prevention, medication utilization rate indications, dosage timing, drug treatment, drug varieties) are adopted for investigation and analysis. The feasibility and effectiveness of the intervention measures are determined through the statistical analysis on the main measurement indexes by comparing before and after the implementation.Objective:The misuse of antimicrobial drugs will be prevented by making the management system on prescription comment and the establishing the management mechanism on prescription comment of clean surgical incision surgical intervention. This management system will reduce the clean cut operation antibacterial drug prevention utilization rate, improve the reasonable usage of antibiotics, and develop a set of practical and effective management mode of prescription comment on the clean cut operation preventing use of antibacterial drugs. Finally, this will improve drug and partial the drug utilization rate, reduce the occurrence of adverse drug reactions, and ensure patients’safety.Methods:The retrospective prescription comment is made in the light of the clean cut prevent use of antimicrobial agents comment table. The mainly content on the comments includes the preventive use of antimicrobial agents, variety selection on antibacterial drugs, the opportunity of use, treatment period of use, combination, dosage, frequency, ways and any basis to replace drugs. Random samples of 360 clean incision surgery hospital medical records which did not implement improvement prescription comment from March to August,2013 and 421 clean implementation of the improved prescription incision surgery by prescription comment from March to August,2015 are selected from top three hospitals in Anhui province. The data are recorded by Excel2007 software. The statistical processing and analysis on the data are made by SPSS 13.0 statistical software, chi-square test is used. The statistical processing and analysis on the data are made by SPSS 13.0 statistical software. The measurement data are described using x±s. The count data are described by rate. Statistical analyses are performed by t-test and chi-square test. The statistically difference was P< 0.05 was considered as significant difference.Results:781 cases, including 360 cases as control group and 421 cases as intervention group, are screened by unified inclusion criteria. The antimicrobial prophylaxis utilization of clean incision surgery in intervention group at the hospital reduced obviously (from 44.17% in the original to 28.74% after prescription comment (P<0.05). It has reached requirements of no more than 30% in the Ministry of Health. 159 cases use antibacterial drugs in 360 cases control group (referred to as the control drug group),121 cases use antibacterial drugs in 421 cases intervention group and in the use of antibacterial drugs (referred to as the intervention drug group). Compare to the control drug group, the rational utilization of clean incision surgery antimicrobial agents improves significantly, from 64.72% to 85.27%(χ2=44.680, P=0.000). Time prevention and treatment of antibiotics used also been further standardized, from 34.59% to 51.24% in reasonable rate(χ2=7.829, P=0.005).The preventive medicine after operation before 0.5-2 hours increased from 45.91% to 71.90%(χ2=35.136, P=0.000). the rate after unused or<24 hours increases from the original 47.80% to 66.12%(χ2=38.687, P=0.000).Conclusions:1. The clean cut operation antibacterial drug prevention utilization r ate reduced effectively, the use of reasonable rate of preventive antibacterial improve d that promoted the rational use of drugs in the clinic through the management interve ntion of prophylactic antibiotics.2. In the improved prescription patterns of comment, the doctor’s some problems were warned and reminded about irrational use of antimicrobial agents, the informati on communication was strengthen between doctors and pharmacists, that the problem of prescription reviews were timely feedbacked and solved.On the other hand, it is c onducive for the pharmacist and physicians to learn and master the relevant profession al knowledge. |
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