État des lieux de l'antibiothérapie aux urgences et intérêt d'une formation ciblée

Abstract : Bacterial resistance to antibiotics is on the increase. Infection represents a frequent reason for presentation to the Emergency Department.The aim of this study was to describe the impact of targetted training sessions and to determine the influence of the awareness measures on the quality of antibiotic prescription in the Emergency Departments in the Annecy Gevevois region. We performed a before and after, multicentred observational study in the adult Emergency Departments in the hospitals in the Annecy Genevois region. We compared whether antibiotic prescription was justified and whether the prescriptions conformed with the reference ANTIBIOGARDE® program, over two periods : before and after training sessions for Emergency Department doctors between December 2014 and July 2016. The justification for use and the conformity of prescriptions (antibiotic used, dose, duration and route of administration) were the principal judgement criteria before and after the interventions. We analysed 600 ‘BEFORE’ and 600 ‘AFTER’ prescriptions. The number of antibiotic prescriptions that were justified and conformed on all criteria was significantly greater following the interventions, 55.7% in 2014-2015 versus 68.8% in 2015-2016 (p<0.001). There was no significant difference (p=0.07) in the justification for antibiotic prescription before and after the interventions. The actual antibiotics prescribed were significantly more suitable (p=0.001) in 2016 (87.9%) than in 2014 (81.7%). Less errors in the posology were made ; 88% correct in 2016 versus 79.3% in 2014 (p<0.001). The route of administration was also significantly more appropriate (p=0.005) un 2016 ; 99.2% in 2016 versus 96.6% in 2014.Training sessions aimed at the most commonly encountered infectious pathologies can improve the good practice of antibiotic prescription. Regular evaluation of prescriptions would be interesting in order to assess the impact of training in the long term.
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Master Thesis
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Submitted on : Thursday, November 23, 2017 - 11:06:00 AM
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Jérémie Karibian. État des lieux de l'antibiothérapie aux urgences et intérêt d'une formation ciblée. Médecine humaine et pathologie. 2017. ⟨dumas-01640317⟩

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