Evaluation of glycopeptide use in nine French hospitals

Details

Serval ID
serval:BIB_D00EE1E45C25
Type
Article: article from journal or magazin.
Collection
Publications
Title
Evaluation of glycopeptide use in nine French hospitals
Journal
Med Mal Infect
Author(s)
Alfandari S., Levent T., Descamps D., Hendricx S., Bonenfant C., Taines V., Cattoen C., Arimane O., Grandbastien B.
Publication state
Published
Issued date
04/2010
Volume
40
Number
4
Pages
232-7
Language
english
Abstract
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.
Keywords
*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
Create date
18/07/2019 12:48
Last modification date
21/08/2019 5:33
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