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Evaluating antibiotic therapies prescribed to adult patients in the emergency department.

Abstract：

OBJECTIVES:The proper use of antibiotics is a public health priority to preserve their effectiveness. Little data is available on outpatient antibiotic prescriptions, especially in the emergency department. We aimed to assess the quality of outpatient antibiotic prescriptions in our hospital. PATIENTS AND METHODS:Retrospective monocentric study of antibiotic prescriptions written to adult patients managed at the emergency department without hospitalization (November 15th, 2012-November 15th, 2013). Prescriptions were evaluated by an infectious disease specialist and an emergency physician on the basis of local recommendations compiled from national and international guidelines. RESULTS:A total of 760 prescriptions were reviewed. The most frequent indications were urinary tract infections (n=263; 34.6%), cutaneous infections (n=198; 26.05%), respiratory tract infections (n=101; 13.28%), and ENT infections (n=62; 8.15%). The most frequently prescribed antibiotics were fluoroquinolones (n=314; 40.83%) and amoxicillin-clavulanic acid (n=245; 31.85%). Overall, 455 prescriptions (59.86%) did not comply with guidelines. The main reasons for inadequacy were the absence of an indication for antibiotic therapy (n=197; 40.7%), an inadequate spectrum of activity, i.e. too broad, (n=95; 19.62%), and excessive treatment duration (n=87; 17.97%). Rates of inadequate prescriptions were 82.26% for ENT infections, 71.2% for cutaneous infections, 46.53% for respiratory tract infections, and 38.4% for urinary tract infections. CONCLUSION:Antibiotic prescriptions written to outpatients in the emergency department are often inadequate. Enhancing prescribers' training and handing out guidelines is therefore necessary. The quality of these prescriptions should then be re-assessed.

journal_name

Med Mal Infect

journal_title

Medecine et maladies infectieuses

authors

Grenet J,Davido B,Bouchand F,Sivadon-Tardy V,Beauchet A,Tritz T,Guyot C,Perronne C,Gaillard JL,Salomon J,Beaune S,Dinh A

doi

10.1016/j.medmal.2016.04.006

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

207-14

issue

4

eissn

0399-077X

issn

1769-6690

pii

S0399-077X(16)30014-2

journal_volume

46

pub_type

杂志文章

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