Antibiothérapie et obésité : quelles adaptations posologiques ?

Abstract : Obese population is submitted to many physiological changes which can alter drug pharmacokinetics especially for antibiotics. Firstly, this work presents a literature review on antibiotics dosing, in obese patients in curative situations for 36 molecules. Secondly, an analysis of 128 antibiotics prescriptions among obese patients in University hospital of Caen provided an evaluation of prescribing practices in this population. This analysis showed that dosages are most of the time prescribed with use of standard dosing regimens and therapeutic drug monitoring is not performed for other antibiotics than aminoglycosides and glycopeptides. Then, in order to support prescribers and pharmacists in antibiotics dosing in obese population, 2 tools, a weight calculator and a synthesis of the literature have been made available on intranet of University hospital of Caen. Finally, a communication campaign including an “institutional” communication and an “interventional” communication to promote tools to both doctors and pharmacists has been performed. Its impact on the use of tools has been evaluated with survey. “Interventional” communication (services of all types) has been more efficient on tools ownership than “institutional” communication for the majority of criteria such as the capacity to find tools (94% of professionnals for “interventional” communication versus 55,6% for “institutional” communication, p = 0.0016). However, the differences were not significant for other criteria.
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Master Thesis
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Submitted on : Thursday, December 20, 2018 - 3:33:39 PM
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Albane Cherel. Antibiothérapie et obésité : quelles adaptations posologiques ?. Sciences pharmaceutiques. 2018. ⟨dumas-01962386⟩

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