Effectiveness of Clinical Pharmacists' Intervention on Perioperative Use of Prophylactic Antibiotics in Patients Undergoing Sterile Operation

OBJECTIVE:To evaluate the perioperative use of prophylactic antibiotics in patients undergoing sterile operation in a three-A grade hospital and the effectiveness of the intervention on antibiotic use.METHODS: We compared the medical records of 548 cases collected before the intervention(from Jan of 2009 to Dec of 2009) with those of 420 cases after the intervention(from June 2010 to May 2011).RESULTS: Of the total 548 cases collected before intervention,all(100%) received antibiotics,with 96 cases(17.5%) receiving antibiotics 0.5-2 hours before operation,92 cases(16.8%) 2-24 hours before operation,and 360 cases(65.7%) after operation;postoperatively,the prophylactic antibiotics were used for an average of 5.21 days;the mean cost of antibiotics was 622.60 Yuan,and the mean hospitalization cost was 11 265.50.Of the 420 cases after intervention,198 cases(47.1%) were not given antibiotics,with 28 cases(6.7%) receiving antibiotics 0.5-2 hours before operation and 22 cases(5.2%) after operation;postoperatively,the prophylactic antibiotics were used for an average of 1.44 days;the mean cost of antibiotics was 176.19 Yuan,and the mean hospitalization cost was 8 724.70 Yuan.The infection rate showed no statistical difference before and after intervention.CONCLUSION: The phenomena of irrational use of prophylactic antibiotics in patients undergoing sterile operation in a three-A grade hospital showed great improvement after intervention yet it is far from the requirement of Ministry of Health(which requires that the application rate of prophylactic antibiotics should be less than 30% in patients undergoing sterile operation).It is urgent to strengthen management and training on surgeons regarding standardized application of antibiotics to achieve safe,effective and economic use of antibiotics.