Evaluation of glycopeptide use in nine French hospitals

Détails

ID Serval
serval:BIB_D00EE1E45C25
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Evaluation of glycopeptide use in nine French hospitals
Périodique
Med Mal Infect
Auteur(s)
Alfandari S., Levent T., Descamps D., Hendricx S., Bonenfant C., Taines V., Cattoen C., Arimane O., Grandbastien B.
Statut éditorial
Publié
Date de publication
04/2010
Volume
40
Numéro
4
Pages
232-7
Langue
anglais
Résumé
BACKGROUND: Adequate glycopeptide use is necessary to optimize efficacy and minimize adverse events and selection of drug resistant microorganisms. METHODS: We performed a multicenter prospective observational study of glycopeptides indications based on modified HICPAC criteria, and quality of prescription based on French consensus recommendations. We assessed the adequacy of indications, loading dose, maintenance dose, administration frequency, serum monitoring and its consequences. RESULTS: We evaluated 117 curative adult prescriptions from nine hospitals. Glycopeptide indications were adequate in 71% with either a clinical (55%) or microbiological justification (27%). The indication was more frequently adequate for vancomycin than for teicoplanin (77% vs. 60%, p=0.04). De-escalation therapy was performed in 48% of all documented infections and 78% of documented infections with betalactam susceptible strains. We observed high rates of correct maintenance dose (90%), administration frequency (88%), and serum monitoring (74%). Loading doses (43%), adequate serum monitoring timing (43%), correction of dose because of inadequate levels (32%) were less adequate. Overall, only three (3%) treatments were adequate for all evaluated items. CONCLUSION: Glycopeptide indications were adequate. However, the quality of prescription can be improved and should focus on loading doses and serum monitoring.
Mots-clé
*Anti-Bacterial Agents/administration & dosage/blood/therapeutic use, *Drug Utilization Review, *Teicoplanin/administration & dosage/blood/therapeutic use, *Vancomycin/administration & dosage/blood/therapeutic use, Adult, Bacterial Infections/*drug therapy, Cross Infection/*drug therapy, Dose-Response Relationship, Drug, Drug Monitoring, Drug Prescriptions/*statistics & numerical data, Drug Resistance, Microbial, France, Guideline Adherence, Hospitals, Private/statistics & numerical data, Hospitals, Public/statistics & numerical data, Hospitals, University/statistics & numerical data, Hospitals/*statistics & numerical data, Humans, Infusions, Intravenous, Prospective Studies, Vancomycin Resistance
Création de la notice
18/07/2019 12:48
Dernière modification de la notice
21/08/2019 5:33
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