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Master Thesis

La mise en place d’un protocole aux urgences du CHOR a-t-elle permis une amélioration de l’adaptation des antibiothérapies dans le respect des recommandations pour les patients consultant aux urgences pour une infection urinaire de traitement ambulatoire ?

Abstract : Urinary tract infections are often managed on an outpatient basis after an ECBU has been performed and probabilistic antibiotic therapy has been initiated. De-escalation of therapy helps to reduce antibiotic resistance. One third of ambulatory physicians receive ECBU's and among them 24% adapt antibiotic therapy. The CHOR has created a protocol to improve this link (patient information and systematic and spontaneous sending of ECBUs). The main objective is to evaluate the post-protocol adaptation of antibiotic therapy in accordance with the recommendations of the SPILF through a retrospective descriptive observational study of professional practices. Patients consulting the emergency department for a urinary tract infection requiring an ECBU and undergoing ambulatory treatment were included prospectively. Data were collected by a hetero-questionnaire. The analysis was done by a Chi2 compliance with a significance level of 0.05. The project was subject to a commitment to comply with a reference methodology with the CNIL. The protocol significantly improved the adaptation of antibiotic therapy according to recommendations when the ECBU was received (47.2% vs <30%, p < 0.008) thanks to an improvement in the transmission of ECBUs (72% vs 24%, p < 0.001) without an improvement in the re-consultation rate (60% vs 53%, p = 0.5). This study is the only one conducted on an intention-to-treat basis and counting only adaptations in accordance with recommendations in the context of urinary tract infections. It includes a recall bias. The methods of transmission of ECBU and the continuing education of general practitioners are areas for improvement.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03254613
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Submitted on : Wednesday, June 9, 2021 - 7:32:40 AM
Last modification on : Tuesday, October 19, 2021 - 5:56:40 PM
Long-term archiving on: : Friday, September 10, 2021 - 6:06:12 PM

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  • HAL Id : dumas-03254613, version 1

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Albane Jossomme. La mise en place d’un protocole aux urgences du CHOR a-t-elle permis une amélioration de l’adaptation des antibiothérapies dans le respect des recommandations pour les patients consultant aux urgences pour une infection urinaire de traitement ambulatoire ?. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03254613⟩

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