Abstract : PURPOSE To assess the relevance of antibiotic combinations according to available recommendations.|
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Abstract : PURPOSE To assess the relevance of antibiotic combinations according to available recommendations.|METHODS Prospective monocentric study of 12-month duration in the department of internal medicine of a teaching hospital. All antibiotic combinations were assessed taking into account the infection type the involved bacteria the antibiotic nature dosage and duration of treatment. A scientific committee classified each combination antibiotic therapy as (1) in agreement with existing recommendations (2) adapted to the antibiogram in the absence of available recommendations (3) irrelevant but with no adverse clinical outcome for the patient (4) irrelevant with potential adverse clinical outcome for the patient.|RESULTS Among 87 antibiotic combinations prescribed 67 (77) agreed with available recommendations. The percentages of irrelevant combinations with and without potential adverse clinical outcome for the patient were 7 (six cases) and 16 (14 cases) respectively. Reasons for non-conformity included (1) prescription of combination therapy while monotherapy could have been sufficient or antibiotic therapy was unjustified (14 cases) (2) prescribed antibiotics not adapted to antibiogram (three cases) (3) prescribed antibiotics not effective on the most likely bacteria when treatment of infection was empirical (three cases). The rate of prescription appropriateness was 97 when the mobile microbiology team had interfered with the decision versus 53 (plt0.001) when it had not.|CONCLUSION: Seventy-seven percent of antibiotic combinations were appropriate and agreed with available recommendations. The advice of a microbiology team markedly improves this rate.|
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