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Master Thesis

Évaluation des pratiques professionnelles : bon usage des carbapénèmes au CHU de Grenoble

Abstract : Carbapenems are reserved for severe infections escaping to others antibiotics. In recent years, carbapenems are being increasingly used in the Grenoble University Hospital, because of the widespread dissemination of antibiotic resistance among Gram-negative bacilli. Infectious disease specialists wanted to audit their establishment. We aimed to evaluate the conformity of carbapenem therapy according to guidelines for nosocomial and community-acquired infections. A prospective study was conducted over a 4 month period at our 2200-bed university hospital, including all adult and pediatric hospitalized patients with carbapenem prescriptions. Compliance with guidelines was assessed by two infectious disease specialists, focusing on the indication, antibiotic choice, dosage and duration of treatment. A total of 152 patients were enrolled in the study (65,4% men). The decision of initiating carbapenem therapy was appropriate in 76,3% of cases. The carbapenem use was adequate in 73,9% of cases for empiric prescriptions and in 77,8% of cases based on antibiogram results. The non-compliance with guidelines was mainly due to prescriptions for community-acquired infections. De-escalation was not possible in 40.3% of patients. De-escalation was performed in only 51.7% of patients when it could be considered. Despite an average of 7.5 day treatment, 23.7% of patients received carbapenems for more than ten days. These results reinforce the need for a strong antibiotic stewardship program in our hospital for the appropriate use of carbapenems.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01141897
Contributor : Jean-Hugues Morneau <>
Submitted on : Tuesday, April 14, 2015 - 9:48:37 AM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
Long-term archiving on: : Tuesday, April 18, 2017 - 6:27:08 PM

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  • HAL Id : dumas-01141897, version 1

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Mélanie van Hollebeke. Évaluation des pratiques professionnelles : bon usage des carbapénèmes au CHU de Grenoble. Sciences pharmaceutiques. 2015. ⟨dumas-01141897⟩

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