目的：了解肇庆市第二人民医院（以下简称“我院”）经尿道前列腺电切围术期抗菌药物的应用情况，结合卫生部《抗菌药物临床应用指导原则》及《中国泌尿外科疾病诊断治疗指南》，为临床合理用药制订方案。方法：根据设计好的调查表，选取2013年1月—2014年12月我院泌尿外科术前无感染或感染已控制的经尿道前列腺电切术病历作回顾性分析。结果：187例经尿道前列腺电切术患者均应用抗菌药物，使用率达100.00％，术后发生感染有20例，感染率为10.69％。围术期使用第1、2、3代头孢菌素作预防感染用药，术后感染发生率无明显差异；抗菌药物应用疗程72 h组术后感染发生率明显＜24、48 h，＞72 h组。结论：我院临床药师为泌尿外科医师制订经尿道前列腺电切术围术期预防应用抗菌药物的方案是：首选第1、2代头孢菌素类，基础疾病较多的老年患者可选用第3代头孢菌素作为预防用药，青霉素过敏者可选用氟喹诺酮类；用药时机为术前30 min，氟喹诺酮类应术前2 h给药；抗菌药物使用疗程为不超过72 h。%OBJECTIVE:To investigate the application of prophylactic antibiotics in the transurethral resection prostate ( TURP) during perioperation in the Second People's Hospital of Zhaoqing ( hereinafter referred to as “our hospital”) , to draw up a program for the clinical rational use of drugs via the combination of Guiding Principles for Clinical Use of Antibiotics and Chinese diagnosis and treatment of urological diseases Guide from Ministry of Health . METHODS:According to the designed questionnaire , patients with TURP that before the urology surgery without infection or the infection has been controlled in our hospital from Jan .2013 to Dec.2014 were selected to conducted the retrospective analysis .RESULTS:187 cases with TURP used antibacterials , the application rate was 100.00%;20 cases was infected after the surgery , the infection rate was 10.69%.The first, second, third generations of cephalosporins were used as the prophylaxis of infection during perioperation , there was no significant difference of the infection rate after the surgery .The postoperative infection rate of antibiotics in the 72h group was significantly less than that in the group of 24 h,48 h and >72 h.CONCLUSIONS:In our hospital, the clinical pharmacists draw up a program of application of prophylactic antibiotics during perioperation of TURP for the urologists: the first, second-generation cephalosporins are the preferred , the elderly patients who have much underlying diseases can choose the third-generation cephalosporins as the prophylaxis , those patients who are allergic to penicillin can choose fluoroquinolones;the administration time is 30 min before the surgery , the fluoroquinolones should be given at 2 h before the surgery .The course of using antibiotics should be no more than 72 h.
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