, communiquer sur l'existence et l'utilité des outils auprès de 3 pharmaciens et 10 internes en pharmacie. Le diaporama PowerPoint ® présenté était identique à celui des 5 services pilotes

, Au 15 mai 2018, le taux de réponses au questionnaire « pharmacie

, Par ailleurs, du point de vue de l'appropriation de la synthèse de la littérature, 82% (n = 9) des personnes l

, Parmi les professionnels ayant déjà consulté la synthèse de la littérature, 33% (n = 3) ont déjà suggéré à un médecin une posologie d'une antibiothérapie pour un patient obèse (contre Réanimation Médecine (Pilotes : hors maladies infectieuses) Chirurgie-blocs opératoires

, Les 2 répondeurs qui n'ont pas consulté la revue le justifient par le fait qu'ils n'ont jamais été confrontés au cas d'un patient obèse nécessitant une antibiothérapie

. Ensuite, 5% (n = 6) des internes en pharmacie et pharmaciens connaissant la localisation des outils, vol.54

, 3% (n=5) l'utilisent à une fréquence d'une fois par mois et 16,7% (n = 1), une fois par semaine, vol.83

, Un tiers des personnes (n = 2) ayant déjà utilisé le calculateur de poids, ont déjà suggéré une posologie, pour un patient obèse, basée sur le poids de calcul donné par cet outil et l'intervention pharmaceutique a été acceptée dans les 2 cas

, L'une fait d'ailleurs la remarque que les outils sont peu visibles au niveau de l'onglet céfotaxime de 200 à 300 mg/kg/jr. Ces molécules, étant hydrophiles et pénétrant peu le tissu adipeux, le calcul des posologies sur le poids total pourrait conduire à des concentrations suprathérapeutiques susceptibles de provoquer des effets indésirables (troubles neuro-psychiques, altération de la fonction rénale). De plus, étant donné l'inexistence des études pour des molécules très fréquemment prescrites comme l'amoxicilline, Enfin, 4 personnes ayant répondu à l'enquête ont proposé des simplifications de l'accès aux outils

A. Noter-que-le-ch-de-lens and . Foch, OMéDIT Centre et l'AEPEI proposent également le calcul des posologies en mg/kg des bêtalactamines sur le poids ajusté

, En effet, pour la ciprofloxacine, certains auteurs, centres hospitaliers, instances ou associations proposent un ajustement des posologies sur le poids ajusté (Fc = 0,45), d'autres proposent l'utilisation des posologies maximales et d'autres suggèrent posologies de 4 mg/kg basées sur le poids total, Il était également très difficile d'établir des recommandations précises pour les fluoroquinolones

, Il faut toutefois préciser que les recommandations d'utilisation, des sociétés savantes, pour les fluroquinolones se font le plus souvent en doses standard et non en mg/kg, rendant l'utilisation du poids ajustée difficile. De plus, seule une étude a conclue que le poids ajusté était adéquate pour la détermination des posologies en ciprofloxacine sans, p.45

, Plusieurs auteurs ne recommandent aucun ajustement des posologies car ils considèrent que le risque d'élévation des CPK est minime tandis que d'autres mettent en avant des études pour lesquelles les doses basées sur le PT voire le PI permettent d'être aussi efficaces que des posologies basées, La daptomycine fait également partie des molécules pour lesquelles il n'est pas possible d'établir des recommandations claires

, En ce qui concerne, la vancomycine, les aminosides, la PTZ, les carbapénèmes et le linézolide, les données de la littérature sont un peu plus codifiées

, Pour la vancomycine, la plupart des auteurs ayant analysé la littérature, proposent un ajustement des posologies sur le poids total (25,40,152). Cependant, il n'existe aucunes données sur la dose de charge (DC) maximale à administrer chez les sujets obèses. De plus, les auteurs ne proposent pas tous la même dose initiale journalière en mg/kg

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