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[Use of antibiotics in emergency units: qualitative and quantitative assessment].

Abstract：

INTRODUCTION:Most antibiotic therapies are initiated in the emergency unit (EU). To better understand the antibiotic consumption survey in this unit, we compared our results to two neighbor hospitals. This quantitative data was then compared to a quality assessment of antibiotic prescription (audit). METHODS:The quantitative measure of antibiotic consumption (three markers: ceftriaxone, amoxicillin-clavulanate, and fluoroquinolones) based on the ratio DDD:1000 patient admitted in the EU was compared between one teaching hospital and the two neighbor hospitals. Qualitative measure: a retrospective clinical targeted audit of antibiotic prescriptions was performed. The compliance to guidelines for infection diagnosis and antibiotic treatment were assessed. RESULTS:Antibiotic consumption: the survey showed a higher consumption of the three antibiotics in the teaching hospital, especially for amoxicillin-clavulanate (3.7-5.5 higher). Audit: 93 files of EU patients were reviewed; their mean age was 71 years (18-96). Diagnosis was conform to the expert opinion in 70% of cases. No antibiotic was really necessary in 20% of cases, and delay between hospitalization and antibiotic prescription was relevant only for 56% of patients. The most frequently prescribed antibiotics were betalactams (penicillins 43%, third generation cephalosporin 21%, and fluoroquinolones 22%). The choice was conform to local and national guidelines in 78% of justified prescribed antibiotherapy. CONCLUSION:The qualitative assessment cannot explain the higher antibiotic consumption trend. The number of unjustified antibiotic prescriptions does not explain the variable antibiotic consumption.

journal_name

Med Mal Infect

journal_title

Medecine et maladies infectieuses

authors

Asseray N,Bleher Y,Poirier Y,Hoff J,Boutoille D,Bretonniere C,Lombrail P,Potel G

doi

10.1016/j.medmal.2008.10.020

subject

Has Abstract

pub_date

2009-03-01 00:00:00

pages

203-8

issue

3

eissn

0399-077X

issn

1769-6690

pii

S0399-077X(08)00344-2

journal_volume

39

pub_type

杂志文章

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