title: An antibiotic stewardship program in a French teaching hospital.
abstract: OBJECTIVE
  An antibiotic stewardship program was implemented in our teaching hospital in 1999, and strengthened in 2005. We report its organization and impact on antibiotic use.
  
  
  METHODS
  This observational study was conducted during a 10-year period (2002-2011).
  
  
  RESULTS
  Many interventions were implemented: Infectious Diseases Specialists (IDS) led systematic ward rounds in several departments (1999); nominative antibiotic order form (2005); documentation of IDS advice in the patient's electronic medical record (2007); IDS advice triggered by the pharmacist (formulary restriction, 2007) or because of positive blood cultures (2009); automated weekly extraction of advice given into a database (2011). Seven thousand two hundred and five pieces of advice were recorded between 2007 and 2011: 63% following physician request, 26% triggered by the pharmacist and 9% because of positive blood cultures. Advice was provided by IDS in 95% of cases (63% by phone). The number of antibiotic prescriptions remained stable since 2005 at around 400 defined daily doses (DDD)/1000 patient-days. Documenting, sharing, and choice of action were improved due to the database.
  
  
  CONCLUSIONS
  Our antibiotic stewardship program is well accepted by physicians and allows controlling antibiotic use in our hospital.
authors.affiliation: Service d'infectiologie, hôpital l'Archet 1, centre hospitalier universitaire de Nice, 151, route Saint-Antoine-de-Ginestière, BP 3079, 06202 Nice cedex 3, France.
authors.forename: V
authors.initials: V
authors.lastname: Mondain
authors.forename: F
authors.initials: F
authors.lastname: Lieutier
authors.forename: S
authors.initials: S
authors.lastname: Dumas
authors.forename: A
authors.initials: A
authors.lastname: Gaudart
authors.forename: T
authors.initials: T
authors.lastname: Fosse
authors.forename: P-M
authors.initials: PM
authors.lastname: Roger
authors.forename: E
authors.initials: E
authors.lastname: Bernard
authors.forename: R
authors.initials: R
authors.lastname: Farhad
authors.forename: C
authors.initials: C
authors.lastname: Pulcini
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy; D003376:Counseling; D016527:Drug Costs; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000706:statistics & numerical data; D057286:Electronic Health Records; D005568:Forms and Records Control; D005602:France; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006748:Hospital Departments; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D055552:Infectious Disease Medicine / Q000458:organization & administration; D016134:Organizational Policy; D010595:Pharmacists; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012380:Role
chemical_list: D000900:Anti-Bacterial Agents