Service pharmacie, Centre hospitalier, Seclin, France
Commission des anti-infectieux, Centre hospitalier, Seclin, France
- Key words: bacteraemia, organisation, compliance
- DOI : 10.1684/jpc.2014.0284
- Page(s) : 133-42
- Published in: 2014
Excessive or inappropriate use of anti-infective contributing to the emergence of bacterial resistance and the risk of therapeutic impasse, their good-use is imperative. The anti-infective prescription in bacteremia, serious medical conditions, is evaluated. Method : A single-center study evaluating professional practices, prospective per-protocol is conducted in 2011 and in 2012 following corrective actions implemented (creating a mobile team of infectious diseases and a shared file tracking bacteremia) by one pharmacist/infectious disease pairs. Compliance with the recommendations and the effectiveness of probabilistic and documented treatment were the primary endpoint. Statistical analysis was performed by Fisher's exact test (two-tailed, 5% significance level). Results: Thirty bacteremia in 2011 (22 pathogens – 8 contaminants) were found against 70 in 2012 (50 pathogens - 20 contaminants). Probabilistic treatment compliance is significantly improved in the second part of the study (2011: 50% - 2012: 84%) (p= 0.004), as well as compliance related to the effectiveness of probabilistic treatment (2011: 46% - 2012: 78%) (p= 0.008). Documented treatment compliance is not significantly improved (2011: 77% - 2012: 84%) (p= 0.354). No anti-infective therapy was added in excess in contaminant bacteremia in both periods. Conclusion: Awareness of the difficulty of treating bacteremia is highlighted by the current state of the practice. The will of gathering and transversales actions leaded by hospital staff about the good-use of anti-infective have been successful and contribute to the optimization of anti-infective care in this type of pathology. Optimization of the good-use of anti-infective in bacteremia continues (evolution of the transverse file, setting up a “checklist” in Staphylococcus aureus bacteremia for compliance with “bundles”).