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Master Thesis

Évaluation des prescriptions de linézolide dans 3 centres hospitaliers de la région Rhône-Alpes

Abstract : Use of linezolid for Gram positive cocci infections is increasing, even in clinical situations where guidelines are very scarce. Currently, linezolid is allowed mainly in pneumonia and complicated skin and soft tissue infections. Overuse and misuse of linezolid can favor the development of linezolid-resistant strains with worrying clinical and epidemiological consequences. Therefore this drug should be preserved for well-defined situations. We retrospectively evaluated linezolid prescriptions’ appropriateness in 3 French hospitals of the Rhône-Alpes region, the way they were prescribed and their compliance to guidelines. Over a three-month period, all prescriptions of linezolid were extracted and analyzed by two independent infectious disease experts. Eighty-one prescriptions were analyzed. Forty eight percent of the initial prescriptions of linezolid were considered appropriate. Among those, only 51% were compliant with international guidelines. 41% of final prescriptions and 35% of whole treatments (initial + final prescriptions) were deemed appropriate. Considering the way they are used, 57% of the prescriptions were adequate. In the end, only 23% of prescriptions combined whole appropriateness and adequacy. The main reasons for inappropriateness included the possibility of choosing narrower-spectrum antibiotics and the empirical use of linezolid in severe sepsis or septic shock. Initial treatment was the most appropriate for all bone and joint infections (p=0.001) whereas it was the most inappropriate for severe sepsis or septic shock (p=0.002). Even if modalities of use were correct in these 3 hospital centers, appropriateness of indications is still too low, especially in severe sepsis or septic shock where this drug was not evaluated. Studies are mandatory to assess the use of linezolid in clinical situations other than pneumonia or complicated skin and soft tissue infections. Pending these data, vancomycin remains the first therapeutic option for most infections with Gram positive cocci resistant to betalactams.
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Master Thesis
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Submitted on : Monday, April 27, 2015 - 4:52:33 PM
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  • HAL Id : dumas-01146131, version 1


Charlotte Dentan. Évaluation des prescriptions de linézolide dans 3 centres hospitaliers de la région Rhône-Alpes. Médecine humaine et pathologie. 2015. ⟨dumas-01146131⟩



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