目的 观察临床药师对结核病围术期预防性使用抗菌药物的干预效果.方法 随机选取 2018 年1-12 月(干预前,n =180)、2020 年1-12 月(干预后,n =174)于广西壮族自治区胸科医院行外科手术治疗的结核病患者病历,比较干预前后预防性使用抗菌药物的情况.结果 干预前围术期预防用药率为 92.78%(167/180),干预后预防用药率为88.51%(154/174),干预前后比较差异无统计学意义(χ2 =1.910,P =0.167).干预后预防用药遴选药物合理率为93.51%(144/154),高于干预前的36.53%(61/167),(χ2 =112.712,P<0.001);干预后给药时机合理率上升为98.70%(152/154),高于干预前的83.83%(140/167)(P<0.01);干预前后术后感染发生率分别为 6.67%(12/180)和5.17%(9/174),差异无统计学意义(χ2 =0.354,P =0.552).干预后,预防性用药时间、住院时间均短于干预前,抗菌药物费用及住院总费用均低于干预前(P<0.05 或P<0.01).结论 临床药师对结核病外科手术围术期预防性使用抗菌药实施干预,可使围术期预防性使用抗菌药物更加趋于规范、合理、安全,缩短患者住院时间,减轻经济负担.
Objective To observe the effect of clinical pharmacists'intervention on the perioperative prevention of the use of antibiotics in tuberculosis.Methods The medical records of tuberculosis patients who underwent surgical treatment in the Chest Hospital of Guangxi Zhuang Autonomous Region in January to December 2018(before intervention,n =180)and January to December 2020(after intervention,n = 174)were randomly selected,the prophylactic use of antibiotics were compared before and after the intervention.Results The perioperative prophylactic medication rate before intervention was 92.78%(167/180),while the preventive medication rate after intervention was 88.51%(154/174).There was no statistically significant difference before and after intervention(χ2 =1.910,P =0.167).The reasonable rate of drug selection for preven-tion after intervention was 93.51%(144/154),which was higher than 36.53%(61/67)before intervention(χ2 =112.712,P<0.001).The reasonable rate of medication timing increased to 98.70%(152/154)after intervention,which was higher than 83.83%(140/167)before intervention(P<0.01).The incidence of postoperative infection before and after intervention were 6.67%(12/180)and 5.17%(9/174),with no statistically significant difference(χ2 =0.354,P =0.552).After the intervention,the duration of preventive medication and hospitalization were shorter than before the intervention,and the cost of antibiotics and total hospitalization were lower than before the intervention(P<0.05 or P<0.01).Conclusion Clinical pharmacists'intervention can make perioperative prophylactic use of antibiotics more standardized,reasonable,and safe on perioperative prophylactic use of antibiotics in tuberculosis surgery,shorten patients' hospital stay,and reduce economic burden.