中国临床药学杂志2025，Vol.34Issue(5)：336-343,8.DOI:10.19577/j.1007-4406.2025.05.003
临床药师干预对骨科Ⅰ类切口手术围术期抗菌药物的预防性使用合理性影响的Meta分析
Effect of clinical pharmacist interventions on rational use of prophylactic antibiotics for Class Ⅰ incision surgery in orthopedics:a meta-analysis
摘要
Abstract
AIM To systematically evaluate the effect of domestic clinical pharmacist intervention in the rational use of antibiotics during the perioperative period of Class Ⅰ incision in orthopedics.METHODS A systematic search was conducted in databases including China National Knowledge Infrastructure(CNKI),WanFang Data,VIP Database,China Biology Medicine Database(SinoMed),PubMed,Embase,Web of Science,and Cochrane Library.Studies published between June 2018 and January 2025 in China were screened,focusing on pharmacist-led pharmaceutical interventions targeting prophylactic antibiotic use in the perioperative period of orthopedic Class Ⅰ incision surgeries.Meta-analysis and presentation of results were carried out by using RevMan 5.4 software.RESULTS A total of 18 studies involving 5 968 patients(intervention group:2 918;control group:3 050)were included.The rational rate of prophylactic antibiotic timing in the intervention group was higher than that in the control group(95.00％vs 78.13％,OR=7.02,95％CI:4.28-11.50,P＜0.01).In the maintenance of antibiotics,the rationality of drug maintenance time in the intervention group was higher than in the control group(72.59％vs 41.87％,OR=6.27,95％CI 2.75-14.31,P＜0.01).In the selection of antimicrobial agents,the selection accuracy of the intervention group was higher than that of the control group(97.74％vs 64.38％,OR=16.10,95％CI 6.11-42.43,P＜0.01).Regarding the preventive utilization rate,the intervention group had a lower rate than the control group(51.86％vs 79.72％,OR=0.18,95％CI:0.10-0.32,P＜0.01).Finally,postoperative surgical site infection incidence was significantly lower in the intervention group than in the control group(1.61％vs 5.73％,OR=0.29,95％CI:0.16-0.53,P＜0.01).CONCLUSION Clinical pharmacist intervention could significantly improve the rational rate of prophylactic administration time and drug maintenance time,as well as the correct rate of drug type selection,and reduce the use rate of antibiotics during the perioperative period and the risk of postoperative infection.关键词
临床药师/干预/骨科Ⅰ类切口/抗菌药物/系统评价Key words
clinical pharmacist/intervention/orthopedic class Ⅰ incision/antibacterials/meta-analysis分类
药学引用本文复制引用
皮聪颖,王子曦,苏灵玉,简怀玉,刘俊彦,邹婷,刘昭前..临床药师干预对骨科Ⅰ类切口手术围术期抗菌药物的预防性使用合理性影响的Meta分析[J].中国临床药学杂志,2025,34(5):336-343,8.基金项目
国家自然科学基金项目(编号82173901) （编号82173901）
湖南省重点研发计划项目(编号2023SK2007) （编号2023SK2007）
