Evaluating antibiotic therapies prescribed to adult patients in the emergency department
Evaluating antibiotic therapies prescribed to adult patients in the emergency department
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DOI：
10.1016/j.medmal.2016.04.006
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发表时间：
2016-06-01
影响因子：
5
通讯作者：
Dinh, A.
中科院分区：
文献类型：
--
作者：
Grenet, J.;Davido, B.;Dinh, A.
目标。 - 正确使用抗生素是保持其有效性的公共卫生优先事项。关于门诊抗生素处方的数据很少，特别是在急诊科。我们的目的是评估我院门诊抗生素处方的质量。患者和方法。 - 对在急诊科未住院的成年患者开具的抗生素处方进行回顾性单中心研究（2012年11月15日至2013年11月15日）。传染病专家和急诊医生根据国家和国际指南编制的当地建议对处方进行了评估。结果。 - 总共审查了 760 个处方。最常见的适应症是尿路感染（n = 263；34.6%）、皮肤感染（n = 198；26.05%）、呼吸道感染（n = 101；13.28%）和耳鼻喉科感染（n = 62；8.15%）。最常用的抗生素是氟喹诺酮类药物（n = 314；40.83%）和阿莫西林克拉维酸（n = 245；31.85%）。总体而言，455 个处方 (59.86%) 不符合指南。不足的主要原因是缺乏抗生素治疗指征（n = 197；40.7%）、活性范围不足，即太宽（n = 95；19.62%）和治疗持续时间过长（n = 87；17.97%）。耳鼻喉科感染处方不足率为82.26%，皮肤感染为71.2%，呼吸道感染为46.53%，尿路感染为38.4%。结论。 - 给急诊科门诊患者开出的抗生素处方往往不足。因此，有必要加强处方医生的培训并分发指南。然后应该重新评估这些处方的质量。 (C) 2016 Elsevier Masson SAS。版权所有。
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. (C) 2016 Elsevier Masson SAS. All rights reserved.