title: Amoxicillin-clavulanic acid prescriptions at the Greater Paris University Hospitals (AP-HP).
abstract: OBJECTIVE
  We aimed to document amoxicillin-clavulanic acid prescription to improve the proper use of antibiotics in hospital settings. We used three criteria: quality of medical charts, adequacy of indications, and adequacy of treatment duration.
  
  
  METHODS
  This study was designed as a one-day point prevalence survey carried out by antibiotic lead specialists.
  
  
  RESULTS
  We included 387 prescriptions from 32 hospitals. Immunodeficiency was recorded as a risk factor in 30% of patients. Computerized prescriptions were observed in 79% of cases. The indication was mentioned in 73% of cases and a 48/78-hour re-assessment of the antibiotic therapy was performed in 54% of cases. The antibiotic indication was primarily for pneumonia and was deemed appropriate in 75% of patients. Adult mean treatment duration was 11.1 days. Use of dual combination therapy and/or treatment duration exceeding two weeks accounted for the main reasons for an inappropriate use of antibiotics. Prescriptions recorded as having been made by senior physicians were of the shortest treatment duration (P=0.0163).
  
  
  CONCLUSIONS
  Medical charts should be better filled in. Reinforcing the role of senior physicians in supervising antibiotic prescriptions is likely to result in a better control of treatment duration and ultimately in a reduced antibiotic consumption. By reinforcing the collaboration between pharmacists and antibiotic lead specialists, the improvement of computerized prescriptions at hospital level should help better detect the "at risk" prescriptions, namely those exceeding seven days or those combining antibiotics.
authors.affiliation: Service évaluation pharmaceutique et bon usage, agence générale des équipements et produits de santé (AGEPS), Assistance publique-Hôpitaux de Paris, Paris, France. Electronic address: isabelle.fusier@aphp.fr.
authors.forename: I
authors.initials: I
authors.lastname: Fusier
authors.affiliation: Service évaluation pharmaceutique et bon usage, agence générale des équipements et produits de santé (AGEPS), Assistance publique-Hôpitaux de Paris, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Parent de Curzon
authors.affiliation: Pharmacie, hôpital Saint-Louis, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Touratier
authors.affiliation: Service des maladies infectieuses et tropicales, hôpital de Bicêtre, Le Kremlin Bicêtre, France.
authors.forename: L
authors.initials: L
authors.lastname: Escaut
authors.affiliation: Maladies infectieuses tropicales, hôpital Saint-Louis, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Lafaurie
authors.affiliation: Équipe d'hygiène hospitalière, direction de l'organisation médicale et des relations avec les universités, Assistance publique-Hôpitaux de Paris, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Fournier
authors.affiliation: Service évaluation pharmaceutique et bon usage, agence générale des équipements et produits de santé (AGEPS), Assistance publique-Hôpitaux de Paris, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Sinègre
authors.affiliation: Direction recherche clinique et développement, hôpital Saint-Louis, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Lechat
authors.affiliation: Service des maladies infectieuses et tropicales, hôpital de Bicêtre, Le Kremlin Bicêtre, France.
authors.forename: D
authors.initials: D
authors.lastname: Vittecoq
mesh_terms: D000328:Adult; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use*; D002648:Child; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D006785:Hospitals, University; D006801:Humans; D010297:Paris; D065093:beta-Lactamase Inhibitors / Q000627:therapeutic use*
chemical_list: D065093:beta-Lactamase Inhibitors; D019980:Amoxicillin-Potassium Clavulanate Combination
keywords: Amoxicilline–acide clavulanique; Amoxicillin–clavulanic acid; Antibiotic stewardship; Bon usage des antibiotiques