DRUGS system enhancing adherence of Chinese surgeons to antibiotic use guidelines during perioperative period.
DRUGS system enhancing adherence of Chinese surgeons to antibiotic use guidelines during perioperative period.
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DOI：
10.1371/journal.pone.0102226
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Wen A
中科院分区：
文献类型：
--
作者：
Yang Z;Zhao P;Wang J;Tong L;Cao J;Tian Y;Yao Z;Wang J;Zhu Y;Jia Y;Wen A
在中国，不合理使用抗菌药物预防术后ssi是一种普遍现象，导致细菌耐药性增加，医院感染率上升，抗菌药物费用增加。本研究旨在评价《药物合理使用指南系统》对外科医生抗菌药物处方行为的影响。选取10例常见外科手术1543例（其中使用纸质指南778例，使用药物765例），收集其人口学和临床资料。选择的手术包括甲状腺切除术、乳房肿块切除术、子宫肌瘤切除术等。评价标准为抗生素给药类别、初始给药时间、给药时间、住院时间、抗生素费用、ssi和药物不良反应（ADR）。抗菌药物大多在切口前0.5 h ~ 2 h给药，656例（85.75%）患者采用药物干预，256例（32.90%）患者采用纸质指南干预。对于清洁伤口切口，使用纸质指南的547例（91.62%）患者在24 h内停药，使用药物的91例（14.79%）。1543例患者共使用了19种抗生素。用药频次前三位分别是哌拉西林舒巴坦钠、头孢硫脒和头孢哌酮。干预后用药频次列表改为头孢唑林、头孢硫脒、头孢哌酮。使用纸质指南和DRUGS的平均住院时间分别为（7.00±4.31）d和（2.54±1.57）d。使用纸质指南和药品的平均费用分别为（3481.36±2584.46）元和（1693.39±1478.27）元。但两组患者ssi发生率和不良反应发生率无显著差异。在这项研究中，在药物订购时增加抗生素指南的可用性，并结合药物，与外科医生对指南的依从性增强有关。
Irrational use of antimicrobial agents for preventing postoperative SSIs is a common phenomenon in China, which results in more bacterial resistance, higher hospital infection rates, extra costs of antimicrobial agents. The aim of the study is to evaluate the effect of Drug Rational Usage Guidelines System (DRUGS) on the surgeon's prescription behavior of antimicrobial agents. 10 common surgical operations which included 1543 cases (where 778 cases using paper-based guidelines and 765 cases using DRUGS) were selected and their demographic and clinical data were collected. The selected operations include thyroid resection, breast mass resection, myomectomy, etc. The evaluation criteria were antibiotic administrative categories, the time of initial dose, duration of administration, length of stay, the costs of antibiotics, SSIs and drug adverse reactions(ADR). The antimicrobial agents were mostly administrated within 0.5 h to 2 h before incision, 656 patients (85.75%) were intervened with DRUGS and 256 (32.90%) with paper-based guidelines according to the protocol. For the clean wounds incision, 547 patients (91.62%) were within 24 h of withdrawal antibiotics with using paper-based guidelines versus 91 (14.79%) with using DRUGS. A total of 19 kinds of antibiotics were used in the 1543 cases. The leading three on the list of frequency were piperacillin and sulbactam sodium, cefathiamidine and cefoperazone. While after the intervention, the list of frequency changed to cefazolin, cefathiamidine, cefoperazone. The average hospital stay was (7.00±4.31)d with paper-based guidelines and (2.54±1.57)d with DRUGS, respectively. The average cost of antibiotics was ¥(3481.36±2584.46) with paper-based guidelines and ¥(1693.39±1478.27) with DRUGS, respectively. However, there were no significant differences in the incidence of SSIs and ADR between two groups. In this study, the increased availability of antibiotic guidelines at the time of drug ordering, combined with DRUGS, was associated with an enhanced surgeon adherence to guidelines.
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影响因子：
3.7
作者：
Li YP;Fang LQ;Gao SQ;Wang Z;Gao HW;Liu P;Wang ZR;Li YL;Zhu XG;Li XL;Xu B;Li YJ;Yang H;de Vlas SJ;Shi TX;Cao WC
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通讯作者：
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作者：
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通讯作者：
Red, L