OBJECTIVE: To establish intervention model of the perioperative prophylactic application of antibacterials for 3 types of clean operations, which can effectively control the irrational use of antibacterials. METHODS: The rationality of antibacterials use in 3 clean surgeries before and after intervention in 10 class 3 grade A hospitals was evaluated and analyzed statistically, and the effective and operative intervention measures were established according to the condition of the region. RESULTS: After the 3 phases of intervention, the utilization ratio of antibacterials reduced to 62.55%, reasonable use rate increased significantly to 49%. Average medication duration decreased from 5.29 d to 1.92 d, and average antibacterial drug costs decreased significantly. After the intervention, antibacterials used reduced to 20 kinds of 4 major categories, the frequency of cefazolin increased significantly (P<0.05). After 3 cycles of intervention, the proportion of preventive medication 0.5~2 h before operation gradually increased. Average antibacterials cost decreased significantly, and irrational uses of antibiotics were improved obviously. CONCLUSION: The research provides a scientific and effective management mode for promoting rational use of antibacterials.%目的:建立3种清洁手术预防用抗菌药物的干预模式,有效控制抗茵药物不合理应用.方法:对广西地区10家三级甲等医院3种清洁手术干预前、后预防用抗茵药物情况进行合理性评价及统计学分析,建立适合本地区有效的、具可操作性的干预措施.结果:经过3个阶段干预,抗茵药物应用率降至62.55％,合理应用率显著提高,达到49％,平均用药疗程由5.29d降至1.92d,平均抗茵药物费用明显下降.干预后抗茵药物应用范围降为4类20种,头孢唑林出现的频次明显升高(P＜0.05).经3轮干预后,预防用药在术前0.5～2h给药例数所占比例逐渐增多,平均抗菌药物费用明显下降,抗茵药物不合理应用情况得到明显改善.结论:本研究可为促进抗茵药物合理应用提供科学、有效的管理模式.
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