title: [Assessment of antibiotic prescriptions in the emergency department of a general hospital. Prospective analysis of 211 prescriptions].
abstract: 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.
authors.affiliation: Service d'accueil des urgences médicales, Centre hospitalier universitaire, F-38000 Grenoble, France. SGennai@chu-grenoble.fr
authors.forename: Stéphane
authors.initials: S
authors.lastname: Gennai
authors.forename: Patricia
authors.initials: P
authors.lastname: Pavese
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Vittoz
authors.forename: Corinne
authors.initials: C
authors.lastname: Decouchon
authors.forename: Sandrine
authors.initials: S
authors.lastname: Remy
authors.forename: Odile
authors.initials: O
authors.lastname: Dumont
authors.forename: Françoise
authors.initials: F
authors.lastname: Carpentier
authors.forename: Patrice
authors.initials: P
authors.lastname: François
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents