title: Impact of a multidisciplinary staff meeting on the quality of antibiotherapy prescription for bone and joint infections in orthopedic surgery.
abstract: BACKGROUND
  We studied the impact of a weekly multidisciplinary staff meeting (MSM) on the quality of antibiotherapy for bone and joint infections in orthopedic surgery, as part of professional practice assessment.
  
  
  METHODS
  We retrospectively studied the file of patients hospitalized for bone and joint infection. We compared antibiotherapy compliance to good use (bacteriology, dose, length of treatment, length of adaptation to microbiology), and outcome at six months for patients with bone and joint infections, before (March 2007 to March 2009) and after (March 2009 to March 2011) implementation of the multidisciplinary staff meeting. We identified 28 patient files (32 infections) before MSM and 26 patient files (28 infections) after MSM.
  
  
  RESULTS
  Antibiotherapy was adapted in 47% of cases before MSM, versus 96% after (P<0.0001). The dose was optimum in 72% of infections before MSM, versus 89% after (P=0.11) and the length of antibiotherapy complied with recommendations in 41% of infections before MSM, versus 86% after (P=0.0005). The average time of antibiotic adaptation to the antibiogram changed from 2 days before MSM to 1.7 days after (P=0.43). Forty seven per cent of patients were cured at six months before MSM, versus 57% after (P=0.45); the rate of treatment failure at six months decreased from 25% before MSM to 18% after (P=0.75).
  
  
  CONCLUSIONS
  The effectiveness of antibiotherapy significantly improved concerning the spectrum and treatment duration (P ≤ 0.0005) after implementing MSMs in orthopedic surgery. But the clinical impact at six months was not significant due to the small population sample.
authors.affiliation: Pharmacie Hospitalière, Centre Hospitalier Intercommunal Robert-Ballanger, 93603 Aulnay-sous-Bois, France.
authors.forename: S
authors.initials: S
authors.lastname: Bauer
authors.forename: M-A
authors.initials: MA
authors.lastname: Bouldouyre
authors.forename: A
authors.initials: A
authors.lastname: Oufella
authors.forename: P
authors.initials: P
authors.lastname: Palmari
authors.forename: R
authors.initials: R
authors.lastname: Bakir
authors.forename: A
authors.initials: A
authors.lastname: Fabreguettes
authors.forename: H
authors.initials: H
authors.lastname: Gros
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000188:drug therapy* / Q000453:epidemiology; D001432:Bacteriology; D004334:Drug Administration Schedule; D004363:Drug Utilization; D050723:Fractures, Bone / Q000150:complications; D006126:Group Processes; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D055552:Infectious Disease Medicine; D033183:Interdisciplinary Communication; D008505:Medical Staff, Hospital; D019637:Orthopedic Procedures; D009985:Orthopedics; D010000:Osteitis / Q000188:drug therapy* / Q000453:epidemiology; D010604:Pharmacy; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011364:Professional Practice; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014946:Wound Infection / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents