Patterns of antibiotic use in hospital-acquired infections

Autor: E. Piednoir, L. Simon, A. Berger-Carbonne, H. Blanchard, C. Dumartin, T. Sevin, S. Alfandari, C. Daniau, S. Le Vu
Přispěvatelé: Santé publique France - French National Public Health Agency [Saint-Maurice, France], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
Rok vydání: 2021
Předmět:
Microbiology (medical)
Adult
medicine.medical_specialty
Epidemiology
Population
Healthcare-associated infections
Fosfomycin
1117 Public Health and Health Services
Hospital
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Internal medicine
Medicine
Antimicrobial stewardship
Humans
030212 general & internal medicine
education
Escherichia coli Infections
0303 health sciences
education.field_of_study
Cross Infection
030306 microbiology
business.industry
Antibiotic
1103 Clinical Sciences
General Medicine
Amoxicillin
Hospitals
3. Good health
Anti-Bacterial Agents
Pivmecillinam
Infectious Diseases
chemistry
Linezolid
Urinary Tract Infections
Ceftriaxone
Prevalence study
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Infection
business
Ertapenem
medicine.drug
Zdroj: Journal of Hospital Infection
Journal of Hospital Infection, WB Saunders, In press, ⟨10.1016/j.jhin.2021.05.008⟩
ISSN: 1532-2939
0195-6701
DOI: 10.1016/j.jhin.2021.05.008⟩
Popis: Summary Background Monitoring the use of antimicrobials in hospitalized patients is critical owing to the risk of resistance selection. This study aimed to describe the patterns of antimicrobial prescription for the most frequent healthcare-associated infections (HAIs) in France, relating drugs and microbiological data. Methods We used data from the 2017 point-prevalence survey of HAI and antimicrobial use in France, a large nationally representative sample survey of inpatients. We sought unambiguous correspondence between individual indications of antibiotic regimen and HAI sites to determine which molecules were directed towards which pathogen, considering its resistance profile. Results Among 75,698 adult patients from 401 hospitals, 5.1% had an active HAI and 4.3% were being treated for an HAI. The two most frequent antibiotic indications were lower respiratory tract (LRTI, 27.7%) and urinary tract infections (UTI, 18.4%). For LRTI, the most prescribed antibiotic was amoxicillin-clavulanic acid (27.6%) and most frequently isolated pathogens (each accounting for around 17% of isolates) were Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. Meticillin-resistant S. aureus LRTI was more likely to be treated with linezolid. For UTI, ofloxacin, ceftriaxone, amoxicillin/co-amoxiclav were most-prescribed (∼13% each) and E. coli predominantly isolated (52.0%). Extended-spectrum beta-lactamase-producing E. coli UTI were more likely treated by fosfomycin, pivmecillinam or ertapenem. Conclusions This study provides a baseline of antimicrobial use in relation to microbiological information in patients with the most common HAIs. These results can serve to direct future efforts in antimicrobial stewardship. Our work could be extended to a broader population, notably in Europe where similar surveys have been conducted.
Databáze: OpenAIRE
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