Page 7 - 《中国药房》2025年10期

·指南与共识·

常见侵入性诊疗操作预防性使用抗菌药物专家共识
Δ

江苏省药学会感染药学专业委员会

中图分类号 R969.3；R978.1 文献标志码 A 文章编号 1001-0408（2025）10-1153-08
DOI 10.6039/j.issn.1001-0408.2025.10.01

摘 要 目的 为临床提供围操作期预防性使用抗菌药物的指导性建议，以提升抗菌药物使用的科学性与合理性。方法 基于《手
术操作分类代码国家临床版3.0》体系，筛选出符合本共识研究范围的诊断性操作、治疗性操作和介入治疗3类侵入性诊疗操作，
按照关键操作技术、入路、推荐意见等进行合并；检索中英文数据库，收集近10年国内外指南/共识及系统性评价，为《抗菌药物临
床应用指导原则（2015版）》（以下简称《指导原则》）未包含操作的预防性使用抗菌药物问题给出推荐意见或对《指导原则》已有操
作的预防性使用抗菌药物问题给出更详细的推荐意见。通过德尔菲法和专家研讨会形成共识推荐意见，以70%的专家同意（专家
达成率）为共识达成标准。结果与结论 共纳入1 164项侵入性诊疗操作条目，经过2轮德尔菲法和3轮专家研讨会最终形成本共
识。相较于《指导原则》，本共识明确给出23条建议预防性使用抗菌药物、21条不建议预防性使用抗菌药物和23条不建议常规预
防性使用抗菌药物的侵入性诊疗操作推荐意见，并细化了高危因素范围与推荐用药时长。本共识为不同侵入性诊疗操作场景下
抗菌药物预防使用提供了明确的指导，有助于提高抗菌药物的使用合理性、减少细菌耐药的发生，同时可能有助于提高侵入性诊
疗操作的安全性，改善患者预后。
关键词 侵入性诊疗操作；抗菌药物；预防；围操作期

Expert consensus on prophylactic use of antimicrobial agents in common invasive diagnostic and
therapeutic procedures
Infectious Diseases Pharmacists Committee of Jiangsu Pharmaceutical Association

ABSTRACT OBJECTIVE To provide the guiding recommendations for the prophylactic use of antimicrobial agents during the
perioperative period in clinical practice， with the aim of enhancing the scientificity and rationality of antimicrobial agents.
METHODS Based on National Clinical Classification and Coding System for Surgical Procedures Version 3.0， three categories of
invasive diagnostic， therapeutic and interventional procedures that fell within the research scope of this consensus were screened
out. These procedures were then consolidated according to key operative techniques， approaches， and recommendations. A search
was conducted through Chinese and English databases for domestic and foreign guidelines/consensus documents and systematic
reviews published in the past decade. The aim was to provide recommendations of prophylactic use of antimicrobial agents for
procedures not covered in the Guiding Principles for Clinical Application of Antimicrobial Agents （2015 edition） （hereinafter
referred to as the Guiding Principles） or to offer more detailed recommendations of prophylactic use of antimicrobial agents for
procedures already included in the Guiding Principles. Consensus recommendations were ultimately formulated through the Delphi
method and expert seminars， with a 70% agreement rate among experts （the consensus achievement rate） serving as the criterion
for consensus attainment. RESULTS & CONCLUSIONS A total of 1 164 entries of invasive diagnostic and therapeutic procedures
were included. After two rounds of the Delphi method and three rounds of expert seminars， this consensus was ultimately
established. Compared to the Guiding Principles， this consensus explicitly proposes 23 recommendations advocating prophylactic
use， 21 recommendations against prophylactic use， and 23 recommendations against routine prophylaxis in invasive diagnostic and
therapeutic procedures. Additionally， it specifies high-risk factor criteria and optimizes the duration of recommended medication.
The consensus offers explicit guidance on the prophylactic use of antimicrobial agents in various scenarios of invasive diagnostic
and therapeutic procedures. It is conducive to enhancing the rational use of antimicrobial agents， mitigating the emergence of
bacterial resistance. Additionally， it may potentially contribute to improving the safety of invasive procedures and optimizing patient
outcomes.
KEYWORDS invasive diagnostic and therapeutic procedures； antimicrobial agents； prophylactic； perioperative period

Δ 基金项目 国家卫生健康委医院管理研究所医院药学高质量发
随着放射介入和内镜诊疗等微创技术的快速发展，
展研究项目（No.NIHAYS2314）
诊断与治疗性操作已经在临床中广泛应用。这些操作
通信作者 邵华，主任药师，博士。研究方向：医院药事管理、临
床药学。E-mail：gycsh@163.com 具有不同程度的侵入性，会对皮肤、黏膜或深层组织造

中国药房 2025年第36卷第10期 China Pharmacy 2025 Vol. 36 No. 10 · 1153 ·