[Assessment of antibiotic prescriptions in the emergency department of a general hospital. Prospective analysis of 211 prescriptions].
OBJECTIVE
To study the appropriateness and conformity to antibiotic prescription guidelines in an emergency department and to assess the factors likely to influence them.


METHODS
This prospective study included all adult patients visiting the emergency department over a period of 100 days and receiving antibiotic treatment. Two independent specialists in infectious disease assessed the appropriateness of the indications and the treatment's conformity with good practice guidelines. We also studied patient's status 7 days after initiation of antibiotic treatment, duration of hospitalization and any treatment changes.


RESULTS
The study included 211 patients, 47% of them men. Prescriptions were appropriate in 53% of cases and in accordance with guidelines in 34%. Half of all prescriptions were related to urinary tract or pulmonary infections. Four antibiotic families accounted for 88% of prescriptions. Prescription errors were related to multidrug treatments, intravenous drugs, and inappropriate antibiotic families. More than half (56%) of the patients were admitted, and 70% of these remained in the hospital more than one week. Duration of treatment was inappropriate for 31% of the patients not admitted. In all, 44% of the antibiotic prescriptions ordered in the emergency department were later modified.


CONCLUSIONS
Multidisciplinary work is essential in improving the quality of antibiotic prescriptions in an emergency department.
Gennai
Stéphane
S
Service d'accueil des urgences médicales, Centre hospitalier universitaire, F-38000 Grenoble, France. SGennai@chu-grenoble.fr
Pavese
Patricia
P
Vittoz
Jean-Philippe
JP
Decouchon
Corinne
C
Remy
Sandrine
S
Dumont
Odile
O
Carpentier
Françoise
F
François
Patrice
P
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital; D005260:Female; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000900:Anti-Bacterial Agents