Retrospective evaluation of the pharmaceutical pathway for prophylactic use of antibiotics during the perioperative period of class Ⅰ neurosurgery incisions
- VernacularTitle:神经外科Ⅰ类切口围手术期抗菌药物预防使用药学路径的回顾性评价
- Author:
Jinping WANG
1
,
2
;
Jie ZHAO
3
;
Chunyan YANG
2
;
Xiaomin LAI
2
;
Yunteng ZHU
2
;
Zhi’ang WU
1
Author Information
1. School of Business Administration，Shenyang Pharmaceutical University，Shenyang 110016，China
2. Dept. of Pharmacy，Shenzhen Second People’s Hospital，Guangdong Shenzhen 518035，China
3. School of Graduate，Guangxi University of Chinese Medicine，Nanning 530000，China
- Publication Type:Journal Article
- Keywords:
pharmaceutical pathway;
neurosurgery;
class Ⅰ incisions;
antibiotics;
prophylactic use of drugs
- From:
China Pharmacy
2024;35(17):2147-2151
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the practicality of the pharmaceutical pathway for prophylactic use of antibiotics during the perioperative period of class Ⅰ neurosurgery incisions. METHODS The previously established pharmaceutical pathway for the prophylactic use of antibiotics in the perioperative period of class Ⅰ neurosurgery incisions was used to retrospectively evaluate the prophylactic use of antibiotics in 127 cases. The “antibiotics prophylactic use scoring system” in the pharmaceutical pathway was used to conduct preoperative scoring， and the patient’s actual antibiotics use was compared and analyzed in combination with existing Guiding Principles for Clinical Application of Antibiotics （2015 Edition） （hereinafter referred to as the Guiding Principles）. The pharmaceutical pathway also innovatively proposes key points for improvement in terms of the frequency of adding antibiotics during surgery and the duration of prophylactic use of antibiotics after surgery. By comparing with the actual medication situation of patients， the direction for updating the Guiding Principles was explored. RESULTS According to the retrospective analysis results， for neurosurgery class Ⅰ incision surgery， in addition to the preoperative prophylactic use of antibacterial drugs for skull mass resection and carotid endarterectomy recommended in the guidelines， endoscopic trigeminal microvascular decompression， arthroscopy and other specific joint examinations， spinal nerve Radical decompression， endoscopic lumbar nucleectomy， dural repair， and spinal canal decompression can also be further explored about the situation of not using antibacterial prophylaxis before surgery； at the same time， for the patients undergoing class Ⅰ neurosurgery incisions， the use of antibiotics during and after surgery may be considered for a second addition of antibiotics， taking into account the surgical time. If cerebrospinal fluid leakage occurred after surgery， it is recommended to extend the duration of prophylactic use of antibiotics appropriately. CONCLUSIONS The application of pharmaceutical pathways can provide more targeted analysis of key points in the prevention of antibiotic use， which promotes the transformation of perioperative antibiotics management for class Ⅰ incisions from “qualitative， empirical” management to “quantitative， scientific” management.
