Robert J, Péan Y, Alfandari S, Bru J-P, Bedos J-P, Rabaud C, Gauzit R
Centre d'Immunologie et des Maladies Infectieuses, CIMI, Team E13 (Bacteriology), Sorbonne Universités, UPMC Univ Paris 06, CR7, INSERM, U1135, 75013, Paris, France.
AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Bacteriology and Hygiene, 75013, Paris, France.
Eur J Clin Microbiol Infect Dis. 2017 Jul;36(7):1083-1090. doi: 10.1007/s10096-016-2892-5. Epub 2017 Jan 9.
In 2011, the French Agency for Safety of Health Products issued guidelines underlining the principles of proper aminoglycosides' use. The aim of the survey was to evaluate adherence to these guidelines two years after their issue. Characteristics of patients receiving aminoglycosides were recorded by voluntary facilities during a 3-month survey in 2013-2014. The modalities of aminoglycosides treatment were analysed by comparison with the French guidelines. A total of 3,323 patients were included by 176 facilities. Patients were mainly hospitalized in medical wards (33.0%), and treated for urinary-tract infections (24.7%). Compliance regarding the clinical indication and the daily aminoglycosides dose was observed in 65.2% and 62.9% of the cases, respectively. A 30-min once-daily IV administration was recorded in 62.5% of the cases. Aminoglycosides treatment duration was appropriate (≤5 days) for 93.6% of the patients. When considering the four criteria together, 23.2% of the patients had a treatment regimen aligned with the guidelines. Requests for measurements of peak and trough AG serum concentrations matched the guidelines in 24.9% and 67.4% of the cases, respectively. Two years after guidelines issue, aminoglycosides use remains unsatisfactory in French health-care facilities. Efforts should be made for guidelines promotion, especially regarding the issue of underdosing.
2011年，法国健康产品安全局发布了强调正确使用氨基糖苷类药物原则的指南。该调查的目的是在指南发布两年后评估其遵循情况。在2013 - 2014年为期3个月的调查中，志愿机构记录了接受氨基糖苷类药物治疗的患者特征。通过与法国指南进行比较，分析了氨基糖苷类药物的治疗方式。176个机构共纳入了3323例患者。患者主要在内科病房住院（33.0%），接受尿路感染治疗（24.7%）。临床适应证和每日氨基糖苷类药物剂量的合规率分别为65.2%和62.9%。62.5%的病例记录为每日一次静脉注射30分钟。93.6%的患者氨基糖苷类药物治疗疗程合适（≤5天）。综合考虑这四个标准时，23.2%的患者治疗方案符合指南。血清氨基糖苷类药物峰浓度和谷浓度测量的要求分别在24.9%和67.4%的病例中符合指南。在指南发布两年后，法国医疗机构中氨基糖苷类药物的使用情况仍不尽人意。应努力推广指南，特别是在用药不足问题方面。
