Issa N, Pedeboscq S, Le Quellec F, Bessède E, Vandenhende M, Bonnet F, Morlat P, Camou F
Service de réanimation médicale, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France.
Service de pharmacie, hôpital Saint-André, CHU de Bordeaux, 33000 Bordeaux, France.
Med Mal Infect. 2016 Feb;46(1):10-3. doi: 10.1016/j.medmal.2015.11.008. Epub 2015 Dec 14.
One of the objectives of the French national plan on antibiotics is to preserve antibiotic effectiveness. A group of infectious disease specialists of the University hospital of Bordeaux aimed to monitor the prescriptions of broad-spectrum antibiotics. Particular attention was paid to carbapenem (CBP) prescriptions given the increase in betalactamase- and carbapenemase-producing bacteria.
We carried out a three-step Professional Practice Evaluation (PPE): evaluation of CBP prescriptions made at the hospital between January and June 2013; CBP prescription training for prescribers; and another evaluation of CBP prescriptions between January and June 2014.
Although the number of admissions remained stable between the two evaluation periods, CBP prescriptions decreased by 16%. The mean treatment duration was stable (9.6 days). Physicians asked for the infectious disease specialist's advice for 82% of CBP prescriptions in 2013 and for 83% in 2014. The number of case patients discussed at the multidisciplinary staff meetings for approval of CBP prescriptions increased from 16% in 2013 to 39% in 2014. Antibiotic de-escalation increased by 61% between the two periods.
Professional Practice Evaluation, supervised by an infectious disease specialist, is a useful addition to weekly multidisciplinary staff meetings to improve CBP prescription.
法国国家抗生素计划的目标之一是保持抗生素的有效性。波尔多大学医院的一组传染病专家旨在监测广谱抗生素的处方情况。鉴于产β-内酰胺酶和碳青霉烯酶细菌的增加，对碳青霉烯类（CBP）处方给予了特别关注。
我们开展了一个分三步的专业实践评估（PPE）：评估2013年1月至6月期间医院开出的CBP处方；对开处方者进行CBP处方培训；以及对2014年1月至6月期间的CBP处方进行另一轮评估。
尽管在两个评估期之间住院人数保持稳定，但CBP处方减少了16%。平均治疗时长保持稳定（9.6天）。2013年82%的CBP处方以及2014年83%的CBP处方，医生都征求了传染病专家的建议。多学科员工会议上讨论以批准CBP处方的病例患者数量从2013年的16%增至2014年的39%。两个时期之间抗生素降阶梯使用增加了61%。
在传染病专家监督下进行的专业实践评估，是对每周多学科员工会议的有益补充，有助于改进CBP处方。
