Carbapenem stewardship program in a French university children's hospital - 25/11/21
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Editor: B. Chabrol
Abstract |
Introduction |
Carbapenems, last-resort antibiotics, are widely used as first-line treatment in patients carrying extended-spectrum beta-lactamases (ESBL) Enterobacteriaceae, including in a pediatric setting. We aimed to implement an antibiotic stewardship program (ASP) to improve the use of carbapenems.
Methods |
We implemented an ASP at the Bordeaux Children's University Hospital with 6-month audits on prescribing practice before and after an intervention (revision of antibiotic treatment protocols, a half-day educational session with feedback of the first study period). The number of carbapenem prescriptions was analyzed and two criteria were used to assess conformity of the indication for carbapenem prescription and conformity of the reassessment. A logistic regression was used to assess the overall compliance of carbapenem prescriptions over the two periods adjusted for ESBL carriage.
Results |
A total of 57 patients were included with 37 carbapenem prescriptions before the intervention and 23 after. Overall carbapenem consumption decreased from 0.54 prescriptions per 100 admissions to 0.32 (p = 0.06). Conformity increased during the study for indication (46–87%, p = 0.004) and for reassessment (48–78%, p = 0.04) and was significantly associated with the second study period, after adjustment for ESBL carriage.
Conclusion |
Our intervention contributed to a significant improvement in the compliance to indications for carbapenem indication and in the reassessment of the prescription.
Le texte complet de cet article est disponible en PDF.Keywords : Antimicrobial stewardship program, Antimicrobial resistance, Carbapenems, Carbapenemases, Extended-spectrum beta-lactamase-producing enterobacteriaceae, pediatric
Plan
Vol 28 - N° 8
P. 621-625 - novembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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