Interventions To Antibiotic Prophylaxis During Perioperative Period Of Spinal Surgery

As one of the important measures to prevent surgical site infection, antibiotic prophylaxis during perioperative period of surgery has been widely used. But the unreasonable antibiotic use cause not only fail to prevent infection, but also increase drug-resistant, adverse drug reactions, etc. Most of spinal surgery use artificial implants, once a patient got infection after surgery it will cause serious consequences such as osteomyelitis, extensive surgery, etc. So the rational antibiotic prophylaxis during perioperative period of spine surgery is very crucial. In order to rule practices of antimicrobial drugs use in surgery, the promulgation of The Modified Clinical Application of Antibacterial Drugs Action Plan had been carried out throughout the country for three years since July,2011. However the rationality of antibiotic prophylaxis during perioperative period of spinal surgery still need further research.Object To explore the changes of using antimicrobial drugs during surgical perioperative period of spinal surgery after the promulgation of The Modified Clinical Application of Antibacterial Drugs Action Plan, analyze the effection of the policy and try to put forward advice for improving the rational use of antimicrobial agents.Materials & Methods To know the status quo of antibiotic prophylaxis during perioperative period of spinal surgery, data storage and the feasibility of data collection by expert consulting,literature reviewing. Then collect the data of patient basic information, antimicrobial drugs information, postoperative situation and related economic indicators from Peking University third hospital's database which is provided by hospital infection management section and information section.. Analyzing the data by using spss17.0.Results & Conclusion1. The influence of the promulgation of The Modified Clinical Application of Antibacterial Drugs Action Plan to regulate behavior of using antimicrobial drugs during surgical perioperative period After the promulgation of The Modified Clinical Application of Antibacterial Drugs Action Plan, practices of antimicrobial drugs use in spinal surgery whereas type I incision during surgical perioperative period has a obviously positive change and the accuracy of using antimicrobial drugs increased. The accuracy of selection,route of administration and combination had a huge improve which were higher than ninty percent. the timing accuracy increased from 6.61% to 50.93% and the duration accuracy increased from 2.67% to 49.8%. At the same time, hospital infection ratio did not improved while the efficiency of the hospital and the economic burden of patients had positive change.2. The problem of using antimicrobial drugs during surgical perioperative period after the promulgation of The Modified Clinical Application of Antibacterial Drugs Action Plan The result shows that although the accuracy of using antimicrobial drugs during surgical perioperative period had been improved after the promulgation of The Modified Clinical Application of Antibacterial Drugs Action Plan, but the accuracywas just 18.69% which was still very low. The low accuracy was influenced by the low accuracy of timing and the low accuracy of duration because over 95% of spinal surgery had artificial implant and the using antimicrobial drugs in these spinal surgery with artificial implant existed these two problems. In addition to these two problems stated above, the accuracy of using antimicrobial drugs during surgical perioperative period in these spinal surgery without artificial implant was also influenced by the irrational use about indication.3. Further suggestion to regulate the use of antimicrobial agents In order to increase the clinical doctor's cognition and gradually change the drug habit, we need to strengthen the conduct of knowledge-propaganda of medicine education, administration and measures such as pharmacist intervention. At the same time, we also should perfect laws and regulations to protect medical workers who had dependence on using antibacterial agents in order to avoid medical disputes.In addition, in view of the management of antimicrobial agents in our country is late, our guide and management measures on different operation and different groups of people is not detailed enough, so we suggest further study on the rational use of drugs.In this way we can manage the use of antimicrobial agents more scientificly.