Étude rétrospective au CHU d’Amiens sur la prise en charge hospitalière des patients admis pour ulcère compliqué de dermohypodermite bactérienne non nécrosante

Abstract : Cellulitis is frequently the result of leg ulcers. During these infectious episodes, microbiological analyses are difficult to interpret. Notably, bacteriological swabs show bacteria on the surface of the ulcer, whose pathogenicity is difficult to determine. This is a retrospective study whose main objective is the description of professional hospital practices concerning antibiotic therapy. The secondary objective is the realization of an inventory of microbiological data provided by the ulcer swab. One hundred and thirty-eight patients were included in our study, the reason being their hospitalisation between 2011 and 2017 for a complicated ulcer ofcellulitis. A bacteriological swab of the ulcer was performed for 52 patients showing 4 bacterial groups: ß-haemolytic streptococci (SBH), Staphylococcus aureus, Pseudomonas spp and enterobacteria, contrasting with 11 positive blood cultures (8 to SBH and 3 to Pseudomonas spp). The majority of patients (76) were treated with amoxicillin / clavulanic acid: the resulting cure rate was 79%. This rate is comparable to the 77% obtained for the 22 patients treated with amoxicillin. Antibiotic therapy was effective on the ulcerous flora in 28 cases with a cure rate of 75%. For 18 patients, antibiotic therapy was not effective against the flora of the ulcer, in which case the cure rate was 61%. Despite the disparity of strains swabbed in the ulcer, antibiotic therapy with amoxicillin / clavulanic acid has a good rate of effectiveness. Future work should include a prospective study comparing response rates with amoxicillin alone.
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Master Thesis
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Inès Devred. Thèse d'exercic...
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Inès Devred. Étude rétrospective au CHU d’Amiens sur la prise en charge hospitalière des patients admis pour ulcère compliqué de dermohypodermite bactérienne non nécrosante. Dermatologie. 2018. ⟨dumas-02068139⟩

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