title: Proper use of carbapenems: Role of the infectious disease specialist.
abstract: OBJECTIVE
  One of the objectives of the French national plan on antibiotics is to preserve antibiotic effectiveness. A group of infectious disease specialists of the University hospital of Bordeaux aimed to monitor the prescriptions of broad-spectrum antibiotics. Particular attention was paid to carbapenem (CBP) prescriptions given the increase in betalactamase- and carbapenemase-producing bacteria.
  
  
  METHODS
  We carried out a three-step Professional Practice Evaluation (PPE): evaluation of CBP prescriptions made at the hospital between January and June 2013; CBP prescription training for prescribers; and another evaluation of CBP prescriptions between January and June 2014.
  
  
  RESULTS
  Although the number of admissions remained stable between the two evaluation periods, CBP prescriptions decreased by 16%. The mean treatment duration was stable (9.6 days). Physicians asked for the infectious disease specialist's advice for 82% of CBP prescriptions in 2013 and for 83% in 2014. The number of case patients discussed at the multidisciplinary staff meetings for approval of CBP prescriptions increased from 16% in 2013 to 39% in 2014. Antibiotic de-escalation increased by 61% between the two periods.
  
  
  CONCLUSIONS
  Professional Practice Evaluation, supervised by an infectious disease specialist, is a useful addition to weekly multidisciplinary staff meetings to improve CBP prescription.
authors.affiliation: Service de réanimation médicale, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France. Electronic address: nahema.issa@chu-bordeaux.fr.
authors.forename: N
authors.initials: N
authors.lastname: Issa
authors.affiliation: Service de pharmacie, hôpital Saint-André, CHU de Bordeaux, 33000 Bordeaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Pedeboscq
authors.affiliation: Service de pharmacie, hôpital Saint-André, CHU de Bordeaux, 33000 Bordeaux, France.
authors.forename: F
authors.initials: F
authors.lastname: Le Quellec
authors.affiliation: Laboratoire de bactériologie, groupe Pellegrin-Tripode, CHU de Bordeaux, 33000 Bordeaux, France.
authors.forename: E
authors.initials: E
authors.lastname: Bessède
authors.affiliation: Service de médecine interne et maladies infectieuses, hôpital Saint-André, CHU de Bordeaux, 33000 Bordeaux, France.
authors.forename: M
authors.initials: M
authors.lastname: Vandenhende
authors.affiliation: Service de médecine interne et maladies infectieuses, hôpital Saint-André, CHU de Bordeaux, 33000 Bordeaux, France.
authors.forename: F
authors.initials: F
authors.lastname: Bonnet
authors.affiliation: Service de médecine interne et maladies infectieuses, hôpital Saint-André, CHU de Bordeaux, 33000 Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Morlat
authors.affiliation: Service de réanimation médicale, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France.
authors.forename: F
authors.initials: F
authors.lastname: Camou
mesh_terms: D001419:Bacteria / Q000187:drug effects / Q000201:enzymology; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D001426:Bacterial Proteins / Q000032:analysis; D015780:Carbapenems / Q000008:administration & dosage* / Q000494:pharmacology; D003953:Diagnosis-Related Groups; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization; D004502:Education, Medical, Continuing; D005602:France; D019983:Guideline Adherence; D006745:Hospital Bed Capacity, 300 to 499; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control* / Q000706:statistics & numerical data; D055552:Infectious Disease Medicine; D033183:Interdisciplinary Communication; D008485:Medical Audit; D008505:Medical Staff, Hospital; D010819:Physician's Role; D011364:Professional Practice; D012017:Referral and Consultation / Q000706:statistics & numerical data; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000032:analysis
chemical_list: D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Antibiotic stewardship; Bon usage des antibiotiques; Carbapenems; Carbapénèmes; Infectious disease specialist; Référent en infectiologie