To analyse the prevention usage situation of the antibiotic application in fracture surgery before and after applying the "Guideline & Rules of antibiotic clinical application" in our hospital.

The clinical data of 348 patients who suffered closed fractures of the extremities with type Ⅰ incision in Department of Orthopaedic Ward 3 in our hospital between January 2010 and December 2014 were collected. The course of treatment, expenses, pharmaceutical proportion of antibiotics, postoperative infective rate and the length of stay (LOS) were analyzed, retrospectively.

There was no significant difference in the age, the sex and the disposition of limbs between the patients before the guideline & rules was implemented (GBI group) and after the guideline & rules was implemented (GAI group). The cases who applying unrestricted antibiotics and restricted antibiotics in the GBI were 20 and 151, respectively, while the cases in the GAI were 165 and 12, respectively, with significant differences (χ² = 232.15, P < 0.001). The course, the expenses and the pharmaceutical proportion of antibiotics in the GBI were (4.006 ± 2.279) days, (839.180 ± 678.177) yuan and (4.674 ± 3.727)%, respectively; while the number in the GAI were (1.492 ± 0.948) days, (58.081 ± 175.449) yuan and (0.239 ± 0.546)%, respectively. There were significant differences in the course, the expenses and the pharmaceutical proportion between patients in GBI group and GAI group (Z =-12.998, -14.746 and -15.270; all P < 0.001). The postoperative infective rate and the average LOA in the GBI were 2.339% and (20.440 ± 16.838) days, respectively; while the number in the GAI were 1.695% and (20.050 ± 13.922) days, respectively. There was no significant difference in the postoperative infective rate and the average LOA between patients in GBI group and GAI group (all P > 0.05).

After the implementation of the "Guideline & Rules of antibiotic clinical application" , the preventive use of antibiotic of our hospital had become more reasonable. The drug grade and the expenses had been descended while the course had been shorted significantly without increasing the infective rate and the average LOA.