| Evaluation of glycopeptide use in nine French hospitals. | |
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MedLine Citation:
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PMID: 19959309 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Adequate glycopeptide use is necessary to optimize efficacy and minimize adverse events and selection of drug resistant microorganisms. METHODS: We performed a multicenter prospective observational study of glycopeptides indications based on modified HICPAC criteria, and quality of prescription based on French consensus recommendations. We assessed the adequacy of indications, loading dose, maintenance dose, administration frequency, serum monitoring and its consequences. RESULTS: We evaluated 117 curative adult prescriptions from nine hospitals. Glycopeptide indications were adequate in 71% with either a clinical (55%) or microbiological justification (27%). The indication was more frequently adequate for vancomycin than for teicoplanin (77% vs. 60%, p=0.04). De-escalation therapy was performed in 48% of all documented infections and 78% of documented infections with betalactam susceptible strains. We observed high rates of correct maintenance dose (90%), administration frequency (88%), and serum monitoring (74%). Loading doses (43%), adequate serum monitoring timing (43%), correction of dose because of inadequate levels (32%) were less adequate. Overall, only three (3%) treatments were adequate for all evaluated items. CONCLUSION: Glycopeptide indications were adequate. However, the quality of prescription can be improved and should focus on loading doses and serum monitoring. |
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Authors:
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S Alfandari; T Levent; D Descamps; S Hendricx; C Bonenfant; V Taines; C Cattoen; O Arimane; B Grandbastien |
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Publication Detail:
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Type: Journal Article; Multicenter Study Date: 2009-12-02 |
Journal Detail:
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Title: Médecine et maladies infectieuses Volume: 40 ISSN: 1769-6690 ISO Abbreviation: Med Mal Infect Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-26 Completed Date: 2010-09-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0311416 Medline TA: Med Mal Infect Country: France |
Other Details:
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Languages: eng Pagination: 232-7 Citation Subset: IM |
Copyright Information:
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Copyright 2009 Elsevier Masson SAS. All rights reserved. |
Affiliation:
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Service de réanimation et maladies infectieuses, centre hospitalier, 155, rue du Président Coty, 59208 Tourcoing, France. alfandari.s@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anti-Bacterial Agents* / administration & dosage, blood, therapeutic use Bacterial Infections / drug therapy* Cross Infection / drug therapy* Dose-Response Relationship, Drug Drug Monitoring Drug Prescriptions / statistics & numerical data* Drug Resistance, Microbial Drug Utilization Review* France Guideline Adherence Hospitals / statistics & numerical data* Hospitals, Private / statistics & numerical data Hospitals, Public / statistics & numerical data Hospitals, University / statistics & numerical data Humans Infusions, Intravenous Prospective Studies Teicoplanin* / administration & dosage, blood, therapeutic use Vancomycin* / administration & dosage, blood, therapeutic use Vancomycin Resistance |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 1404-90-6/Vancomycin; 61036-62-2/Teicoplanin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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