Baclet Nicolas, Forestier Emmanuel, Gavazzi Gaëtan, Roubaud-Baudron Claire, Hiernard Vincent, Hequette-Ruz Rozenn, Alfandari Serge, Aumaître Hugues, Botelho-Nevers Elisabeth, Caraux-Paz Pauline, Charmillon Alexandre, Diamantis Sylvain, Fraisse Thibaut, Gazeau Pierre, Hentzien Maxime, Lanoix Jean-Philippe, Paccalin Marc, Putot Alain, Ruch Yvon, Senneville Eric, Beuscart Jean-Baptiste
CHU Lille, University of Lille, F-59000 Lille, France.
Groupe Hospitalier de l'Institut Catholique (GHICL), Service de Maladies Infectieuses, Université Catholique de Lille, F-59160 Lille, France.
Antibiotics (Basel). 2024 Mar 20;13(3):283. doi: 10.3390/antibiotics13030283.
In geriatrics, explicit criteria for potentially inappropriate prescriptions (PIPs) are useful for optimizing drug use.
To produce an expert consensus on explicit definitions of antibiotic-PIPs for hospitalized older patients.
We conducted a Delphi survey involving French experts on antibiotic stewardship in hospital settings. During the survey's rounds, the experts gave their opinion on each explicit definition, and could suggest new definitions. Definitions with a 1-to-9 Likert score of between 7 and 9 from at least 75% of the participants were adopted. The results were discussed during consensus meetings after each round.
Of the 155 invited experts, 128 (82.6%) participated in the whole survey: 59 (46%) infectious diseases specialists, 45 (35%) geriatricians, and 24 (19%) other specialists. In Round 1, 65 explicit definitions were adopted and 21 new definitions were suggested. In Round 2, 35 other explicit definitions were adopted. The results were validated during consensus meetings (with 44 participants after Round 1, and 54 after Round 2).
The present study is the first to have provided a list of explicit definitions of potentially inappropriate antibiotic prescriptions for hospitalized older patients. It might help to disseminate key messages to prescribers and reduce inappropriate prescriptions of antibiotics.
在老年医学中，潜在不适当处方（PIPs）的明确标准有助于优化药物使用。
就住院老年患者抗生素PIPs的明确定义达成专家共识。
我们对法国医院环境中抗生素管理方面的专家进行了德尔菲调查。在调查过程中，专家们对每个明确的定义发表意见，并可提出新的定义。至少75%的参与者给出的李克特评分为7至9分的定义被采纳。每轮调查后在共识会议上讨论结果。
在155名受邀专家中，128名（82.6%）参与了整个调查：59名（46%）传染病专家、45名（35%）老年病专家和24名（19%）其他专家。在第一轮中，采纳了65个明确的定义，并提出了21个新定义。在第二轮中，又采纳了35个其他明确的定义。结果在共识会议上得到验证（第一轮后有44名参与者，第二轮后有54名）。
本研究首次提供了住院老年患者潜在不适当抗生素处方的明确定义清单。它可能有助于向开处方者传播关键信息，并减少抗生素的不适当处方。
