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Master Thesis

Évaluation de la pertinence des prescriptions d'antifongiques au centre hospitalier universitaire de Grenoble

Abstract : Objectives: The aim of this study was to assess adequacy and conformity of systemic antifungal drugs prescriptions in comparison with local, French, European and international recent guidelines in the Grenoble teaching hospital.
Patients and methods: Each prescription of itraconazole, liposomal amphotericin B, voriconazole, caspofungin, micafungin, posaconazole and anidulafungin made between February and October 2010 were reviewed by an infectious diseases specialist. Fluconazole prescriptions' were reviewed only for 15 days.
Results: Two hundred and eight patients received 295 systemic antifungal prescriptions. Most of them had at least one risk factor, and immunodeficiency was one of the most common. Antifungal treatment starting, molecules choice, administrations conformity (dosage, administration way) were appropriate in 126 cases on 208 (60.5%) at the treatment beginning evaluation and in 171 cases on 295 (58%) at the treatment ending evaluation. Antifungal combinations (9.4%) were less frequent than in the study carried out in Grenoble teaching hospital in 2007 (16.3%). Most common non-conformities encountered were use of caspofungin instead of others antifungal treatments like fluconazole, antifungal combinations prescription, administration modalities misguiding (loading dose lack, inadequate dosage or administration way). The economy that could have been generated (by considering inappropriate treatments and less expensive alternatives) represented 18% of the antifungal budget of 2010 in the Grenoble teaching hospital.
Conclusions: An improvement was highlighted in the antifungal prescriptions in comparison to the previous study led in 2007 in the Universitary Grenoble hospital [33]. However, the antifungal use is not optimal and further training is planned.
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Master Thesis
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  • HAL Id : dumas-00614968, version 1


Laetitia Fabien. Évaluation de la pertinence des prescriptions d'antifongiques au centre hospitalier universitaire de Grenoble. Sciences pharmaceutiques. 2011. ⟨dumas-00614968⟩



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