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Master Thesis

Impact d'une rupture d'approvisionnement de Piperacilline-Tazobactam sur la consommation des antibactériens et la prise en charge des pneumonies au centre hospitalier de l'université de Montréal

Abstract : Drug shortages affect a wide range of drugs in Canada, including antimicrobial agents. Piperacillin-tazobactam, the most used antibiotic for pneumonia treatment at the Montreal University Hospital Center (CHUM), went on shortage between December 2017 and February 2018. The goal of this study was to assess the impact of this shortage on overall use of antibiotics at the CHUM. We also aimed at evaluating the proper use of antibiotics and the compliance with pneumonia treatment guidelines. We compared the overall consumption of antibiotics, using the days of therapy (DOT) per 1,000 days present during the shortage (n) and during the same period the year before (n-1) and the year after (n+1) at the CHUM. We also compared the empiric antibiotic treatment used in adult patients, hospitalized for pneumonia during those same periods. We focused on guidelines compliance and patient outcomes. Results showed a 46% decrease of piperacillin-tazobactam consumption and an increase in the use of broad-spectrum and at high risk for C. difficile infections antibiotics, such as carbapenems (+93%) and third-generation cephalosporins (+129%), during the shortage. Pneumonia treatments were consistent with guidelines in 31.9% (n-1), 46.2% (n) and 40.1% (n+1) of cases. Piperacillin-tazobactam shortage is similar to antimicrobial stewardship restrictive interventions. These interventions have proven to be effective in improving the proper use of antibiotics. However, it also led to an increase of the use of broad-spectrum antibiotics. Therefore, antimicrobial stewardship will have to reinforce its action by using persuasive interventions to anticipate and manage the impact of shortages.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02301893
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Submitted on : Friday, October 25, 2019 - 10:13:43 AM
Last modification on : Wednesday, July 15, 2020 - 8:56:03 AM
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  • HAL Id : dumas-02301893, version 1

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Matthieu Beuvelet. Impact d'une rupture d'approvisionnement de Piperacilline-Tazobactam sur la consommation des antibactériens et la prise en charge des pneumonies au centre hospitalier de l'université de Montréal. Sciences pharmaceutiques. 2019. ⟨dumas-02301893⟩

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