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目的提高以头孢唑啉为主短程策略预防剖宫产手术部位感染的实施情况。方法制定有循证基础的以一代头孢菌素为主短程预防剖宫产手术部位感染抗菌药物预防性使用指南(以下简称《指南》)。2009年9月～2011年8月对某院妇产科全部剖宫产病例进行前瞻性手术部位感染监测,并每月对围手术期预防性抗生素使用情况进行反馈。自2010年3月～2010年8月进行干预。结果干预前、干预中、干预后预防剖宫产手术部位感染的抗菌药物使用对《指南》的依从率逐步提高,分别为20.80%,63.34%,90.91%,P<0.001;手术部位感染分别为0.73%(2/274),1.06%(3/284),0.00%(0/550),P<0.01;抗菌药物费用下降,分别为83.36(48.6,145.80),6.30(2.10,72.90),2.10(2.10,6.30)元,P<0.001。结论对短程应用以头孢唑啉为主预防剖宫产术后感染指南的依从性在干预下明显提高,安全经济。
Objective To improve cefazolin-based short-stroke strategy to prevent the implementation of cesarean section infection. Methods To develop an evidence-based guideline for the prophylactic use of antimicrobial agents for the prevention of cesarean section at the first generation of cephalosporins (hereinafter referred to as the “Guideline”). From September 2009 to August 2011, all cases of cesarean section in a hospital were monitored for prospective surgical site infection and monthly feedback on the use of perioperative prophylactic antibiotics. From March 2010 to August 2010 for intervention. Results The compliance rate of the guideline before intervention, intervention and intervention for the prevention of cesarean surgical site infections were gradually increased (20.80%, 63.34%, 90.91%, P <0.001). The surgical site infections were 0.73% (2/274), 1.06% (3/284), 0.00% (0/550), P <0.01. The costs of antimicrobial drugs decreased by 83.36 (48.6,145.80), 6.30 (2.10,72.90) and 2.10 (2.10,6.30) yuan, P <0.001. CONCLUSIONS: The compliance with short-course cefazolin-based guidelines for the prevention of post-cesarean section infection was significantly improved under safe intervention.