title: Appropriateness of aminoglycoside prescriptions in a French university hospital.
abstract: BACKGROUND
  Aminoglycosides are a major class of antibiotics. Their use is particularly interesting in the treatment of severe infections but their toxicity is well known. They are mostly prescribed combined with other agents and as first-line treatments. We aimed to assess the appropriateness of aminoglycoside prescriptions in a French university hospital on the basis of the latest French recommendations published in 2011.
  
  
  METHODS
  We conducted a prospective study between January 17th and February 4th, 2014 to assess prescription modalities of aminoglycosides on the basis of the following criteria: indication, duration of treatment, dosing schedule, administration modalities, and drug level monitoring. Prescriptions were then compared to the 2011 national guidelines.
  
  
  RESULTS
  A total of 68 consecutive prescriptions were analyzed and only 47.8% complied with guidelines. Most physicians complied with recommendations, particularly with the indication for severe infections (95.6%), the administration of a single daily dose (92.6%), and the slow intravenous infusion (30minutes) administration (84%). However, physicians tended to prescribe lower doses than recommended (40.3%), especially to patients presenting with renal insufficiency, and drug level monitoring was not optimal.
  
  
  CONCLUSIONS
  Although new and accurate national recommendations were recently published, aminoglycoside prescription is still not optimal, in particular for dosing and plasma concentration monitoring.
authors.affiliation: Centre Hospitalier Régional Universitaire, Université de Franche-Comté, UMR 6249 Chrono-environnement, Service d'Hygiène Hospitalière, Besançon, France. Electronic address: a3muller@chu-besancon.fr.
authors.forename: A
authors.initials: A
authors.lastname: Muller
authors.affiliation: Centre Hospitalier Régional Universitaire, Université de Franche-Comté, UMR 6249 Chrono-environnement, Service de Maladies Infectieuses, Besançon, France.
authors.forename: J
authors.initials: J
authors.lastname: Leroy
authors.affiliation: Centre Hospitalier Régional Universitaire, Service de Bactériologie, Besançon, France.
authors.forename: I
authors.initials: I
authors.lastname: Patry
authors.affiliation: Centre Hospitalier Régional Universitaire, Pharmacie centrale, Besançon, France.
authors.forename: T
authors.initials: T
authors.lastname: Hénon
authors.affiliation: Centre Hospitalier Régional Universitaire, Université de Franche-Comté, UMR 6249 Chrono-environnement, Service d'Hygiène Hospitalière, Besançon, France.
authors.forename: D
authors.initials: D
authors.lastname: Hocquet
authors.affiliation: Centre Hospitalier Régional Universitaire, Université de Franche-Comté, UMR 6249 Chrono-environnement, Service de Maladies Infectieuses, Besançon, France.
authors.forename: C
authors.initials: C
authors.lastname: Chirouze
authors.affiliation: Centre Hospitalier Régional Universitaire, Université de Franche-Comté, UMR 6249 Chrono-environnement, Service d'Hygiène Hospitalière, Besançon, France.
authors.forename: X
authors.initials: X
authors.lastname: Bertrand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000617:Aminoglycosides / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D000073602:Antimicrobial Stewardship / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents
keywords: Aminoglycosides; Aminosides; Antibiotic stewardship; Bon usage des antibiotiques