title: [Impact of sugammadex on neuromuscular blocking agents use: a multicentric, pharmaco-epidemiologic study in French university hospitals and military hospitals].
abstract: BACKGROUND
  Seven Neuromuscular Blocking Agents (NMBA) are commercialized in France. Four of them have an intermediate duration of action. Sugammadex required the use of NMBA slightly employed in clinical practice in France. Its introduction in routine practice could have an impact on NMBA use in clinical practice. This study was then conducted to assess and compare NMBA use before and after the commercialization of sugammadex.
  
  
  METHODS
  A longitudinal, retrospective, observational study was conducted between 2008 and 2011 in French university hospitals and military hospitals. The consumption data for sugammadex and NMBA were collected using a collection grid which was filled by pharmacists or anesthesiologists. Drug use was measured by the number of vials used divided by the annual number of hospitalizations in surgery and obstetrics (HSO). An overall analysis of the annual frequency of NMBA use was firstly performed, then individual data of each hospital were analyzed. Descriptive statistical analysis including mean, standard deviation, median, minimum and maximum was achieved.
  
  
  RESULTS
  Thirty-four out of 39 hospitals participated in the study (87%) and analysis was performed on 26 of them (7%). The data of eight institutions were excluded due to missing values or because of the non-admission of sugammadex in their formulary. The NMBA mostly used were non-steroidal NMBA (75% of market share) with an increased use between 2008 and 2011 concerning atracurium (from 41 to 51 vials of 50mg atracurium used per 100 HSO). The overall analysis revealed an increase of the occurrence of rocuronium (between 2008 and 2011: from 1 to 4.8 vials of 50mg rocuronium used per 100 HSO). Individual analyses on each hospital showed a possible effect of sugammadex introduction on NMBA use in nine hospitals.
  
  
  CONCLUSIONS
  The commercialization of sugammadex seems to have induced a discrete increase of steroidal NMBA but non-steroidal NMBA remain the leading agent in France. A long-term follow-up is deserved.
authors.affiliation: Service pharmaceutique, hospices civils de Lyon, groupement hospitalier Est, 59, boulevard Pinel, 69677 Bron cedex, France.
authors.forename: K
authors.initials: K
authors.lastname: Beny
authors.forename: V
authors.initials: V
authors.lastname: Piriou
authors.forename: C
authors.initials: C
authors.lastname: Dussart
authors.forename: R
authors.initials: R
authors.lastname: Hénaine
authors.forename: G
authors.initials: G
authors.lastname: Aulagner
authors.forename: X
authors.initials: X
authors.lastname: Armoiry
mesh_terms: D000732:Androstanols / Q000037:antagonists & inhibitors; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D001279:Atracurium / Q000037:antagonists & inhibitors; D004363:Drug Utilization; D005602:France; D006772:Hospitals, Military / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D009466:Neuromuscular Blocking Agents / Q000037:antagonists & inhibitors; D009467:Neuromuscular Depolarizing Agents / Q000037:antagonists & inhibitors; D003473:Neuromuscular Nondepolarizing Agents / Q000037:antagonists & inhibitors; D017891:Pharmacoepidemiology; D012189:Retrospective Studies; D000077123:Rocuronium; D013256:Steroids; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000627:therapeutic use*
chemical_list: D000732:Androstanols; D009466:Neuromuscular Blocking Agents; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D013256:Steroids; D047408:gamma-Cyclodextrins; D001279:Atracurium; D000077122:Sugammadex; D000077123:Rocuronium
keywords: Anesthesiologists clinical practice; Consommation curares; Neuromuscular blocking agents use; Pratiques de curarisation; Sugammadex