title: Informal consultation at a teaching hospital infectious diseases department.
abstract: BACKGROUND
  Informal consultations for advice in the infectious diseases department (IDD) induce a significant workload for physicians. Our aim was to retrospectively quantify and describe this activity in our institution.
  
  
  METHODS
  The data was obtained from files documented and faxed by physicians from October 2009 to May 2012. One thousand nine hundred and seventy-two files were included. The file was faxed to the IDD specialist, analyzed, then a telephone conversation allowed making precisions, and the documented form was faxed back.
  
  
  RESULTS
  The requests for advice concerned 39% of female and 61% of male patients with a mean age of 64±21 years. Twenty-nine percent of requests came from surgical departments and 71% from medical departments (P<0.01). The departments most frequently concerned were cardiology (10%), gastro-enterology (10%) and cardiovascular surgery (9.7%). The most frequent infections were urogenital (19%), osteoarticular (14%), and cardiovascular (11%). Forty-nine percent were considered as nosocomial and 25.3% were bacteremic. The requests concerned diagnostic aid in 16.2% of cases and therapeutic issues in 95.6%. The IDD specialist made therapeutic recommendation in 96.5% of cases and gave diagnostic advice in 43.7%. Treatment modification was suggested in 38.5% of cases. Twenty-two percent of consultations required a second one.
  
  
  CONCLUSIONS
  This study documented the importance of antibiotic changes among medical and surgical units, the increasing need of these units to be helped, and also the complexity of the medical cases, all requiring the advice of an ID specialist. Our fax-phone-fax procedure seems to prevent the bias associated with informal consultations by phone, which is the most commonly used in other institutions.
authors.affiliation: Infectious Diseases Department, Dijon Teaching Hospital, BP 97908, 21000 Dijon, France.
authors.forename: C
authors.initials: C
authors.lastname: Rameau
authors.affiliation: Infectious Diseases Department, Dijon Teaching Hospital, BP 97908, 21000 Dijon, France.
authors.forename: S
authors.initials: S
authors.lastname: Mahy
authors.affiliation: Infectious Diseases Department, Dijon Teaching Hospital, BP 97908, 21000 Dijon, France.
authors.forename: A-L
authors.initials: AL
authors.lastname: Simonet Lamm
authors.affiliation: Infectious Diseases Department, Dijon Teaching Hospital, BP 97908, 21000 Dijon, France.
authors.forename: A
authors.initials: A
authors.lastname: Fillion
authors.affiliation: Infectious Diseases Department, Dijon Teaching Hospital, BP 97908, 21000 Dijon, France.
authors.forename: M
authors.initials: M
authors.lastname: Buisson
authors.affiliation: Infectious Diseases Department, Dijon Teaching Hospital, BP 97908, 21000 Dijon, France.
authors.forename: A
authors.initials: A
authors.lastname: Waldner
authors.affiliation: Infectious Diseases Department, Dijon Teaching Hospital, BP 97908, 21000 Dijon, France.
authors.forename: M
authors.initials: M
authors.lastname: Duong
authors.affiliation: Infectious Diseases Department, Dijon Teaching Hospital, BP 97908, 21000 Dijon, France.
authors.forename: L
authors.initials: L
authors.lastname: Piroth
authors.affiliation: Infectious Diseases Department, Dijon Teaching Hospital, BP 97908, 21000 Dijon, France. Electronic address: pascal.chavanet@chu-dijon.fr.
authors.forename: P
authors.initials: P
authors.lastname: Chavanet
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D005260:Female; D005568:Forms and Records Control; D005602:France; D006748:Hospital Departments / Q000458:organization & administration* / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D006920:Hygiene; D055552:Infectious Disease Medicine / Q000458:organization & administration* / Q000706:statistics & numerical data; D008297:Male; D008499:Medical Records; D008511:Medicine / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000458:organization & administration* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016636:Telefacsimile; D013689:Telephone
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiothérapie appropriée; Appropriate antibiotherapy; Consultation informelle; Informal consultation; Recommandations; Recommendation