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Master Thesis

Évaluation pluridisciplinaire de la conformité aux recommandations de l'usage des carbapénèmes par la mise en place d'un Antimicrobial Stewardship Program au Centre Hospitalier Universitaire de Caen

Abstract : Antibiotic resistance has been constantly increasing as a result of the use of antibiotics (ATB). Carbapenems (CBP), often considered as “last resort” ATB, have been used increasingly more frequently, resulting in the emergence of carbapenemases-producing bacteria because of selection pressure, thus creating a risk of therapeutic impasse. The objective of this study is to evaluate the relevance of the initiations of CBP treatments within the University Hospital, through the establishment of a CBP management program. This prospective study lasted for 5 months in the intensive care unit (ICU), the surgery unit and the medical unit, where the conformity to recommendations of each initiation of a carbapenem treatment has been evaluated by an infectious disease specialist. The follow-up to these evaluations has been collected. 104 files were included in the study. The prescriptions have been predominantly empirical (n = 67), for a pulmonary location (n = 36), and were initiated in the intensive care unit (n = 52). The percentage of nonconformity rose up to 18% (n = 19) and the opinion of the infectious disease specialists has complied in 68% of the cases (n = 13). The non-conformity and the average duration of treatment were significantly lower in the case of empirical prescriptions (p < 0.001). The prescriptions of CBP within the medical unit have had a conformity rate which was statistically superior to those of the ICU (p = 0.037). The follow-up of these encouraging results and the sustainability of the ATB management program focused on CBP and other critical anti-infective agents of our institution are decisive tools in order to combat antibiotic resistance.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01907522
Contributor : Ufr Santé Unicaen <>
Submitted on : Monday, October 29, 2018 - 11:15:14 AM
Last modification on : Saturday, April 11, 2020 - 6:08:48 PM

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  • HAL Id : dumas-01907522, version 1

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Jérémy Perron. Évaluation pluridisciplinaire de la conformité aux recommandations de l'usage des carbapénèmes par la mise en place d'un Antimicrobial Stewardship Program au Centre Hospitalier Universitaire de Caen. Sciences pharmaceutiques. 2017. ⟨dumas-01907522⟩

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