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Master Thesis

Infections cutanées d’origine staphylococcique : évaluation des pratiques professionnelles en soins primaires en Nouvelle-Calédonie

Abstract : Antibiotic resistance is a major concern nowadays. In New Caledonia, the increase in the prevalence of community-acquired SARM in the recent years is poorly understood. We hypothesize that inadequate care of skin infections, widely linked to this pathogen, could be responsible, notably with respect to antibiotics overuse. We investigated physicians practice regarding these infections, in particular local care, microbiological documentation, antibiotic therapy and decolonisation. We here propose a descriptive transversal study of practices declared by self-administered questionnaire from Caledonian physicians in primary care from February to March 2020. We report antibiotic misuse and poor knowledge of decolonisation. Non-indicated antibiotic therapy is sometimes prescribed, and for excessive periods of time. Clavulanic amoxicillin acid and fusidic acid are largely used, despite their maladjustment to local ecology. SARM rates are underestimated by 40% of practitioners. This misuse can be explained by lack of information, professional training and local reference frames. Moreover, these skin infections are preferentially found within the melanesian population, of which the majority lives in tribes. Medical doctors who are aware of the socio-economic constraints that this involves may be inclined to move away from recommendations. These inappropriate practices, associated with the presence of a SARM clone fit to its environment and to a particularly high prevalence of skin infections, probably contributes to the propagation of SARM on this territory. To tackle this phenomenon, effective communication between healthcare professionals, health authorities and the population, as well as a better collective prevention of this infection are crucial.
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Master Thesis
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Submitted on : Wednesday, February 3, 2021 - 11:48:31 AM
Last modification on : Saturday, February 13, 2021 - 3:10:00 AM
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  • HAL Id : dumas-03130060, version 1



Eve Fayollet. Infections cutanées d’origine staphylococcique : évaluation des pratiques professionnelles en soins primaires en Nouvelle-Calédonie. Médecine humaine et pathologie. 2021. ⟨dumas-03130060⟩



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