[Audit on antibiotic prescriptions in a department of infectious diseases].
OBJECTIVE
France is one of the countries that prescribe the most antibiotics. The inappropriate use of antibiotics participates in the emergence of multi-resistant bacteria. This study was aimed at assessing the adequation of antibiotic prescriptions in a hospital department of internal medicine-infectious diseases.


METHODS
Over a two-month period, all the antibiotics treatments were analysed prospectively. The adequation of the treatments was analysed at first with regard to the various consensus conferences of the French-speaking Society of infectious diseases (Société de pathologie infectieuse de langue française (Spilf)) and then with regard to the bacteriological results.


RESULTS
One hundred and five prescriptions were analysed during the study period. Thirty-five percent of prescriptions were inadequate with regard to the criteria used. In 22 cases the prescription was excessive, in 8 cases it was unjustified and in 5 cases it was inappropriate. Moreover, in univariate analysis, 3 factors were correlated with inadequation: prescriptions drawn-up by a non-infectious disease practitioner (OR =3.45, IC 95% 1.34-9.09, p=0.008), prescriptions drawn-up by junior in the department (OR =4.10, IC 95% 1.54-11.08, p=0.003) and prescriptions pour respiratory infections (OR=2.58, IC 95% 1.03-6.48, p =0.04).


CONCLUSIONS
This study conducted in a department of infectious diseases reveals the persisting high rate of inappropriate prescriptions, confirming the need to develop control and retro-control strategies regarding the prescription of antibiotics in order to control the diffusion of multi-resistant bacteria.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003141:Communicable Diseases / Q000188:drug therapy; D018432:Drug Resistance, Multiple; D005260:Female; D005602:France; D019983:Guideline Adherence; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
D000900:Anti-Bacterial Agents