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Titre du document / Document title

Prospective assessment of fluoroquinolone use in a teaching hospital

Auteur(s) / Author(s)

MEAN M. (1) ; PAVESE P. (1) ; VITTOZ J. P. (2) ; FORONI L. (3) ; DECOUCHON C. (1) ; STAHL J. P. (1) ; FRANCOIS P. (2) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Maladies Infectieuses, Département de Médecine Aiguë et Spécialisée, Centre Hospitalier Universitaire de Grenoble, BP 217, 38043 Grenoble, FRANCE
(2) Unité d'évaluation, Département de Veille Sanitaire, Centre Hospitalier Universitaire de Grenoble, BP 217, 38043 Grenoble, FRANCE
(3) Département de Pharmacie, Centre Hospitalier Universitaire de Grenoble, BP 217, 38043 Grenoble, FRANCE

Résumé / Abstract

The aim of this study was to review the use of fluoroquinolone (FQ) drugs in a teaching hospital and to bring to light the factors associated with FQ misuse. A prospective observational study of FQ prescriptions was conducted in a 2,200-bed teaching hospital. Every hospitalized patient receiving a FQ drug during the 3-week survey period was included. A questionnaire was filled out using medical records and face-to-face interviews with FQ prescribers. An infectious diseases specialist reviewed the questionnaires and analyzed FQ therapy according to local guidelines for FQ prescription. Among the group of 174 patients included, FQ therapy was inappropriate in 88 cases (50.6%; 95% CI 43-58) for the following reasons: inappropriate clinical setting, 43; non-first-line recommendation, 24; inappropriate choice of FQ agent, 9; and inappropriate combination of FQs, 12. FQ prescriptions did not comply with prescription rules in 45 cases (25.9%; 95% CI 20-33). Appropriateness and compliance overlapped for 17 of these 45 patients who received an inappropriate FQ course that did not comply with prescription rules. Finally, FQ therapy was misused for 116 of the 174 patients (66.6%; 95% CI 59-74). Characteristics linked with FQ misuse were hospitalization in surgical wards (p=0.03), intravenous therapy (p<0.01), and presumptive therapy (p=0.05). The FQ misuse rate progressively decreased during the survey period (p=0.04). FQ misuse was a common phenomenon in the teaching hospital studied. The significant improvement in FQ prescribing practices observed during the study period demonstrates that frequent review of antibiotic use with prescribers is warranted.

Revue / Journal Title

European journal of clinical microbiology & infectious diseases    ISSN  0934-9723 

Source / Source

2006, vol. 25, no12, pp. 757-763 [7 page(s) (article)] (33 ref.)

Langue / Language

Anglais

Editeur / Publisher

Springer, Heidelberg, ALLEMAGNE  (1988) (Revue)

Mots-clés anglais / English Keywords

Antibacterial agent

;

Teaching hospital

;

Fluoroquinolone derivatives

;

Infection

;

Mots-clés français / French Keywords

Antibactérien

;

Centre hospitalier universitaire

;

Fluoroquinolone dérivé

;

Infection

;

Mots-clés espagnols / Spanish Keywords

Antibacteriano

;

Centro hospitalario universitario

;

Fluoroquinolone derivado

;

Infección

;

Localisation / Location

INIST-CNRS, Cote INIST : 19903, 35400014314299.0030

Nº notice refdoc (ud4) : 18318869



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