Misuse of antibiotics reserved for hospital settings in outpatients: a prospective clinical audit in a university hospital in Southern France

Autor: Charléric Bornet, Manon Roche, Piseth Seng, Philippe Monges, Andreas Stein, Sophie Gensollen
Přispěvatelé: Assistance Publique - Hôpitaux de Marseille (APHM), Institut de Chimie Radicalaire (ICR), Aix Marseille Université (AMU)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Service des Maladies Infectieuses et Tropicales [Hôpital de la Conception] (SMIT), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)
Rok vydání: 2016
Předmět:
Zdroj: International Journal of Antimicrobial Agents
International Journal of Antimicrobial Agents, Elsevier, 2016, 48 (1), pp.96-100. ⟨10.1016/j.ijantimicag.2016.03.015⟩
International Journal of Antimicrobial Agents, 2016, 48 (1), pp.96-100. ⟨10.1016/j.ijantimicag.2016.03.015⟩
ISSN: 0924-8579
DOI: 10.1016/j.ijantimicag.2016.03.015
Popis: 26th European Congress of Clinical Microbiology and Infectious Diseases ă (ECCMID), Amsterdam, NETHERLANDS, APR 09-12, 2016; International audience; Some antibiotics are reserved essentially for hospital settings owing to ă cost effectiveness and in order to fight the emerging antibiotic ă resistance crisis. In some cases, antibiotics reserved exclusively for ă use in hospitals may be prescribed in outpatients for serious infections ă or in the absence of a therapeutic alternative. A 30-day prospective ă audit of outpatient prescriptions of antibiotics reserved exclusively ă for use in hospitals was performed. The objective of this study was to ă evaluate the relevance of outpatient antibiotic prescriptions by ă measuring appropriateness according to guidelines. During the study ă period, 53 prescriptions were included, only 40% of which were ă appropriate. Among the 32 inappropriate prescriptions, 4 cases lacked ă microbial arguments, 1 case was not adequate for the infection type, 1 ă case involved an incorrect antibiotic dosage, 1 case involved an ă incorrect interval of dose administration, 3 cases had a therapeutic ă alternative and 22 cases were not recommended. Of the 53 prescriptions, ă 66% were started in hospital and 34% in outpatients. Only 25% of ă cases were prescribed with infectious diseases specialist (IDS) advice, ă 64% were based on microbiological documentation and 13% had a negative ă bacterial culture. Inappropriate prescriptions were usually observed in ă antibiotic lock therapy, skin infections, Clostridium difficile colitis, ă intra-abdominal infections and intravascular catheter-related ă infections. Outpatient prescriptions of antimicrobial drugs reserved ă exclusively for use in hospitals are frequently inappropriate. We ă recommend a real-time analysis algorithm with the involvement of an IDS ă for monitoring prescriptions to improve the quality of these ă prescriptions and possibly to prevent antibiotic resistance. (C) 2016 ă Elsevier B. V. and International Society of Chemotherapy. All rights ă reserved.
Databáze: OpenAIRE
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