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Journal de Pharmacie Clinique

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Protocol of antibiotics therapy in neutropenic subject infections : impact on expenses of a department of haematology Volume 18, issue 1, Mars 1999

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The antibiotic strategy of fever episodes neutropenic patients has been the subject of several experts recommendations or consensus conferences. At the Nice CHU, the antibiotic therapy in neutropenic patient with temperature is set up according to a consensus protocol. In December 1996, this protocol was discussed in order to choose less expensive molecules. End of June 1997, a first report of expenses was drawn up. The impact of the new protocol expenses was assessed in the Internal Medicine 1 department, haemato-oncology oriented, of the Cimiez Hospital. In 1996 and 1997, the activity of this healthcare unit for the 6 first months of the year is comparable, about 10 400 days + sessions. The combination ceftazidime + amikacine + vancomycine was replaced in January 1997 by ticarcilline-clavulanic acid + netilmicine + vancomycine. Since January 1997, 400 000 F were saved on all anti-infectious drugs, 64 000 F are directly linked to the new protocol settlement. For each molecule, a comparison between 1996 and 1997 was done showing a plain reduction of ceftazidime, amikacine prescriptions in profit of the combination ticarcilline-clavulanic acid and netilmicine. Haematology is one of the most antibiotics consuming disciplines. The therapeutic strategy of neutropenic subject infections must lead to economic studies guaranteeing a bacteriological efficacy at low cost. Indeed, it is difficult to show that a beta-lactamine or an aminoside is clinically superior to another, as far as their spectrum is comparable.