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目的:调查急性阑尾炎手术患儿围手术期抗菌药物的使用情况,为围手术期抗菌药物的合理应用提供依据。方法:对某院普外科2011年7月-2014年8月急性阑尾炎手术患儿围手术期抗菌药物的用药选择、给药剂量、给药频次、给药疗程、联合用药、更换药物等进行回顾性分析,依据《抗菌药物临床应用指导原则》,判断是否合理使用抗菌药物。结果:735例急性阑尾炎手术患儿抗菌药物使用率为100%,共应用抗菌药物8类18种,用药选择以β-内酰胺类抗生素、硝基咪唑类为主,单一用药433例次(占38.76%),二联用药684例次(占61.24%),以头孢菌素类和硝咪唑类联用为主,无三联用药;应用合理601例(占81.77%),应用基本合理32例(4.35%),应用不合理102例(占13.88%);术前均应用抗菌药物。结论:该院急性阑尾炎手术患儿围手术期抗菌药物应用存在药物选择不当、无指征频繁换药、抗菌谱重叠、疗程较长等现象,因此加强急性阑尾炎患儿围手术期抗菌药物使用的管理和干预,对提高抗菌药物合理用药水平具有非常重要的意义。
Objective: To investigate the use of perioperative antibiotics in children with acute appendicitis and provide basis for the rational application of perioperative antibacterials. Methods: A retrospective study was conducted on perioperative antimicrobial drug selection, dosage, frequency of administration, medication course, combination therapy and drug replacement in children with acute appendicitis from July 2011 to August 2014 in a department of general surgery. Sex analysis, based on “clinical guidelines for antimicrobial agents,” to determine whether the rational use of antimicrobial agents. Results: The use of antimicrobial agents was 100% in 735 children with acute appendicitis. A total of 18 kinds of antimicrobial agents were used in 8 categories. The main drugs were β-lactam antibiotics and nitroimidazoles, with 433 single doses 38.76%), 684 cases (61.24%) in combination with cephalosporins and nitrofurazone, and no triple therapy was used. There were 601 cases (81.77%) with rational use and 32 cases with rational use 4.35%), the application of unreasonable 102 cases (13.88%); preoperative antimicrobial drugs. Conclusion: The perioperative application of antimicrobial drugs in children with acute appendicitis in this hospital has improper drug selection, frequent indication of drug replacement, overlapping antimicrobial spectrum and long course of treatment. Therefore, the use of perioperative antibiotics in patients with acute appendicitis Management and intervention, to improve the rational use of antimicrobial drugs has a very important significance.