title: An information campaign on aminoglycosides use during septic shock failed to improve the quality of care.
abstract: BACKGROUND
  Septic shock remains a major cause of death in intensive care units (ICU) and an inappropriate antibiotic regimen worsens the prognosis. The aim of the study was to assess the impact of an information campaign on modalities of prescription of aminoglycosides in septic shock.
  
  
  METHODS
  A prospective observational study.
  
  
  METHODS
  Consecutive septic shock patients admitted to the surgical ICU over a 2-year period were included. An information campaign allowed to differentiate between a pre- (P1) and a post- (P2) interventional period. The campaign clarified the rules and requirements for pharmacological monitoring of aminoglycosides. The main objective was to increase the rate of prescription of peak serum aminoglycoside following the first intravenous injection.
  
  
  RESULTS
  One hundred and forty-eight patients (P1=76 and P2=72) were finally included into the study. Similar clinical characteristics were observed during both periods. The rate of prescription of peak serum aminoglycoside following the first injection was performed in 49% (P1) versus 65% (P2), P=0.09. The length of stay in ICU was 16 days [extremes: 1-74] (P1) versus 17 days [extremes: 1-133] (P2) (P=0.84). Inhospital mortality was 28% (P1) versus 26% (P2), P=0.86.
  
  
  CONCLUSIONS
  An information campaign describing the modalities of prescription of aminoglycosides in septic shock failed to improve medical practices and patient outcomes. A mobile team of antibiotics could be useful in daily practice.
authors.affiliation: Pôle anesthésie-réanimation-Samu-Smur-coordination hospitalière-hémovigilance, CHU de Caen, France. fischer-mo@chu-caen.fr
authors.forename: M-O
authors.initials: MO
authors.lastname: Fischer
authors.forename: J-J
authors.initials: JJ
authors.lastname: Parienti
authors.forename: C
authors.initials: C
authors.lastname: Daurel
authors.forename: D
authors.initials: D
authors.lastname: Debruyne
authors.forename: R
authors.initials: R
authors.lastname: Verdon
authors.forename: J-L
authors.initials: JL
authors.lastname: Gérard
authors.forename: J-L
authors.initials: JL
authors.lastname: Hanouz
authors.forename: J-L
authors.initials: JL
authors.lastname: Fellahi
mesh_terms: D000368:Aged; D000617:Aminoglycosides / Q000008:administration & dosage / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods; D016903:Drug Monitoring; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D023381:Endpoint Determination; D005260:Female; D017052:Hospital Mortality; D006784:Hospitals, Teaching; D006801:Humans; D033181:Information Dissemination; D007362:Intensive Care Units / Q000458:organization & administration; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010346:Patient Care Management; D011446:Prospective Studies; D058996:Quality Improvement; D018401:Sample Size; D012772:Shock, Septic / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents