- 期刊
南台灣某醫學中心外科手術使用預防性抗生素之初步分析
Preliminary Evaluation of Prophylactic Antibiotic Use in Surgical Patients in a Medical Center in Southern Taiwan
摘要
正確的給予預防性抗生素，可以有效的降低手術後傷口感染率。某醫學中心蒐集2001年4月17日至2001年5月16日，該中心一般外科及整形外科手術病患所使用的「預防性抗生素」處方，依據手術傷口類別，參考文獻對於預防性抗生素使用的共識，評估「預防性抗生素」在術前及術後用藥的適當性及術後傷□ 感染情形。分析107位病患，共107人次的手術中，清潔傷口手術48例，清潔-污染傷口手術43例，污染及骯髒傷口手術16例。在分析案例中，術前藥物選擇不當佔41.1％、起始給藥時間不在術前1小時內37.0％、藥物劑量不當35.3％及術後用藥天數不當47.2％。術後3個月內追蹤手術傷口預後，發現有6位因傷口再度感染住院或延長住院天數。對於「預防性抗生素」的正確用藥觀念，尚有待檢討及加強教育宣導之必要。
並列摘要
It is documented that proper use of prophylactic antibiotic is capable of reducing the incidence of post-operation surgical site infection. In order to audit the prophylactic antibiotic practice in our institute, we performed a prospective evaluation of the use prophylactic antibiotic in our patients undergoing surgery between April 17, 2001 to May 16, 2001. During the study period, 107 sessions (patient-cases) of surgery performed in 107 patients were found. Each surgery session was regarded as an individual case, which was enrolled for analysis. All patients¡¦ medical charts were prospectively reviewed with particular reference to the prescribed prophylactic antibiotic(s), timing and dosing the prescribed prophylactic antibiotic(s), as well as the length of antibiotic prophylactic time. It was found that 44 cases (41.1%) having inappropriate¡¦ prescribed prophylactic antibiotic(s), 34 cases (37.0%) having inappropriate timing of starting prophylactic antibiotic(s) (beyond one hour prior to operation), 18 cases (35.3%) having inappropriate dosing of prophylactic antibiotic antibiotic(s), and 43 cases (47.2%) having inappropriate length of antibiotic prophylactic antibiotic(s) times. During the 3-month post-operation follow-up, six patients were found to be re-hospitalized or to prolong their hospital stay due to surgical site infection. The present study discloses that the prophylactic antibiotic practice in our surgical patients failed to live up to the current evidence-based recommendation, and indicates that education for updating the prophylactic antibiotic practice for surgeons is in urgent need.
被引用紀錄
延伸閱讀
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