Kouakou-Siransy Gisèle, Horo Kigninlman, Effo Etienne, Kamenan Alexis, N'guessan-Irié Geneviève, Boko-Kouassi Alexandre, Aka-Anguy Elisabeth, Die Kakou Henri
Int J Clin Pharmacol Ther. 2015 Nov;53(11):940-6. doi: 10.5414/CP202349.
Acute community-acquired pneumonia in Côte d'Ivoire, mainly in the pneumology units, is the second most common cause of hospitalization after tuberculosis. This study aimed to evaluate the compliance of antibiotic therapy during bacterial acute community-acquired pneumonia with international guidelines serving as frame of reference at the University Hospital of Cocody.
We carried out a descriptive retrospective and analytic study on 62 hospitalized patients from December 1, 2008 to November 30, 2010 in the Pneumophtisiology department at the University Hospital of Cocody (Abidjan). The prescription of antibiotics was compared with the recommendations of the 15th consensus conference on anti-infectious therapy by the Société de Pathologie Infectieuse de Langue Francaise (SPILF) (French Speaking Society of Infectious Pathology) held in 2006.
The main antibiotics prescribed were amoxicillin-clavulanic acid (42.27%), netilmicin (34.5%) and ciprofloxacin (6%). The antibiotic therapy diagrams were dominated by an antibiotic bitherapy; the association of amoxicillin-clavulanic acid+netilmicin was observed in 80.64% of the prescriptions. An antibiotic monotherapy was reported in 14.52% of the prescriptions. Apyrexia at 72 hours was obtained with 64% of the patients with nonstop antibiotic treatment, 24% of them presented a lack of apyrexia, and 12% of them died. The lack of apyrexia at 72 hours treatment correlated with concomitant administration of cotrimoxazole with prophylactic doses among HIV positive patients. The level of the compliance with the SPILF recommendations is low (3.6%).
Thus, our results convey the necessity to draw up national recommendations because of the specific realities of countries with limited incomes.
在科特迪瓦,急性社区获得性肺炎主要发生在肺病科,是继结核病之后第二常见的住院原因。本研究旨在评估在科科迪大学医院,以国际指南为参照标准的细菌性急性社区获得性肺炎抗生素治疗的依从性。
我们对2008年12月1日至2010年11月30日在科科迪大学医院(阿比让)肺病生理学科住院的62例患者进行了描述性回顾性分析研究。将抗生素处方与2006年法国感染病理学会(SPILF)召开的第15届抗感染治疗共识会议的建议进行比较。
主要使用的抗生素为阿莫西林-克拉维酸(42.27%)、奈替米星(34.5%)和环丙沙星(6%)。抗生素治疗方案以双联抗生素治疗为主;80.64%的处方中观察到阿莫西林-克拉维酸与奈替米星联合使用。14.52%的处方采用单一抗生素治疗。64%持续接受抗生素治疗的患者在72小时时退热,24%的患者未退热,12%的患者死亡。72小时治疗时未退热与HIV阳性患者预防性使用复方新诺明有关。对SPILF建议的依从性较低(3.6%)。
因此,由于低收入国家的具体实际情况,我们的研究结果表明有必要制定国家建议。