[Profile of patients facing therapeutic problems in nosocomial infections due to methicillin-resistant staphylococci--A survey of practices].
Methicillin-resistant staphylococcal infections (MRSI) are still common in an intensive care setting. Their management is mainly based on glycopeptides, combined with other antibiotics when this is possible, and also on treatment of the portal of entry (removal of foreign bodies, surgery...). Implementation of this antibiotic therapy may meet with difficulties linked to the micro-organism (existence of strains with diminished sensitivity to glycopeptides), to the toxicity of glycopeptides or to the unfavourable course of the infection. A survey of practices was performed on a representative sample of 240 intensive care units in France. Glycopeptides, and particularly vancomycin, were the most frequently employed and prescribed in combination with other compounds. Therapeutic problems were considered as occasional, their incidence ranging from 0 to 50%. The problems reported were mainly linked to adverse effects: most frequently renal toxicity and, to a lesser extent, immunological and allergic complications. Diminished sensitivity to glycopeptides was only reported by a third of physicians, and this sporadically. Such a survey of practices is an essential preliminary to an epidemiological study of the incidence of MRSI and related therapeutic problems.
Sollet
J P
JP
Centre hospitalier Victor-Dupouy, 95107 Argenteuil, France.
Gauzit
R
R
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D003422:Critical Care; D003428:Cross Infection / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology*; D003625:Data Collection; D005602:France; D006020:Glycopeptides; D006801:Humans; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects*; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents; D006020:Glycopeptides