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Analysis of antibiotic prescription in A&E

Analysis of antibiotic prescription in A&E. FVH 5-15 Octobre 2009 H. Lecoeur. Methods and results. Data record : from October 5 to October 15 62 Antibiotic Prescriptions Duration : 3 to 8 days 4 patients hospitalized: AECB receiving Ceftriaxone

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Analysis of antibiotic prescription in A&E

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  1. Analysis of antibiotic prescription in A&E FVH 5-15 Octobre 2009 H. Lecoeur

  2. Methods and results • Data record : from October 5 to October 15 • 62 Antibiotic Prescriptions • Duration : 3 to 8 days • 4 patients hospitalized: • AECB receiving Ceftriaxone • Angiocholitis Ceftriaxone-Metronidazole • 2 Pneumonias Ceftriaxone • (Patients hospitalized before Atb prescription ?)

  3. Results • 6 Antibiotic Combinations • Angiocholitis Ceftriaxone-Metronidazole • Pharyngitis Ciprofloxacin-Azithromycin • UTI Ciprofloxacine-Bactrim • Pyelonephritis Ceftriaxone-Amikacine • Hand Cellulitis Oxacilline-Dalacine • Abscess/Scar Ciprofloxacin-Metronidazole

  4. Prescriptions

  5. Recommandations Respiratory Tract Infections

  6. Recommandations Digestive, urinary and cutaneous infections

  7. E. coli resistance / FVH(1000 samples, 300 positive, 94 E. coli, 1 Isolate/patient)

  8. Ciprofloxacine • In vitro : most active FluoroQuinolone against Gram negative bacilli • In vivo : • Most active if given by infusion • Poor PK parameters by oral way • Not to be given to children and teen-agers (given in 2 teens aged 16 and 17 )

  9. Prescription of « Restricted Antibiotics » in FV paediatrics

  10. General recommandations • No prescription against viral respiratory diseases • In Pharyngitis-Tonsilitis: • Only Streptococcus pyogenes to be treated • Penicilline or Macrolides • No need for Amox-AcClac • Limit « oral » Ciprofloxacin • Limit antibiotic combination • Think : • most probable bacteria • resistance phenotype : wild or not • severity : need for combination or not • tolerance • Guide for Antibiotic Prescription 2009

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