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Master Thesis

Intérêt de l'antigénurie pneumocoque dans la prise en charge des pneumopathies aiguës communautaires aux urgences de Pau

Abstract : Introduction : The pneumococcal urinary antigen (PUA) is commonly used in clinical practice in the CAP. However, its contribution to the diagnosis and treatment of CAP aid remain controversial. The aim of this observational study to Pau emergencies is threefold. First, whether the realization of UPA change antibiotic prescribing practices. Second, whether the result of UPA once made amends established antibiotics. Tercio, assess the compliance rate with the recommendations AFSSAPS 2010 therapeutic modalities and type of antibiotic, the Pau emergencies during the study period. Materials and methods : Observational study, prospective, single-center divided into two periods conducted from October 2013 to January 2015 in Pau emergencies. PAC were included immunocompetent adults having no admission in intensive care unit (ICU) criteria. During a first period « WITH » the AUP was performed systematically unlike the second period « WITHOUT ». The antibiotic introduced to emergencies were recorded, and the duration of antibiotic therapy, the rate and duration of hospitalization, mortality rates and transfer resuscitation. Results : 155 patients enrolled, including 81 in the «WITH» group and 74 in the « WITHOUT » group. The UPA positive rate is 35%. We have not found significant differences on established antibiotic, mortality, ICU transfer rate, the length of hospital stays and antibiotic in the « WITH » group and « WITHOUT ». There are no non-significant difference on the same criteria that the test is positive or negative. 98% of introduced antibiotic covered Streptococcus pneumoniae. For ambulatory patients, 33% of antibiotic comply with recommendations (amoxicillin and clavulanic acid prescribed instead of amoxicillin alone), 74% for hospitalized patients (25% instead of biantibiothérapies recommended monotherapies). A saving of about 42 000 euros was made when testing the blocking during the six months period « WITHOUT ». Conclusion : The completion of the pneumococcal antigenuria did not change the antibiotic of CAP to Pau emergencies or morbidity and mortality. We recommend not to perform in non-severe CAP.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01468056
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Submitted on : Wednesday, February 15, 2017 - 10:30:25 AM
Last modification on : Wednesday, August 23, 2017 - 4:41:37 PM
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Chahid El Ghattas. Intérêt de l'antigénurie pneumocoque dans la prise en charge des pneumopathies aiguës communautaires aux urgences de Pau. Médecine humaine et pathologie. 2016. ⟨dumas-01468056⟩

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