Abstract
BACKGROUND: There is a major risk in the development of antibiotic resistance in Europe, with a particular rise in antibiotic resistance to piperacillin-tazobactam. Countries such as Lithuania, Bulgaria or Italy already suffer from this increase in resistance to antibiotics (European Centre for Disease Prevention and Control, 2015).(1) As elsewhere in France, the overuse of piperacillin-tazobactam in our university hospital has represented a warning signal, for the Anti-Infective Committee in particular (+107.8%).(2) PURPOSE: The aim of this study is to evaluate the use of piperacillin-tazobactam within a university hospital. MATERIAL AND METHODS: During 2 months, all electronic prescriptions of piperacillin-tazobactam and manual prescriptions for units which do not benefit from electronic prescriptions were analysed in order to evaluate their compliance and their relevance with clinical and biological data registered in patient records. RESULTS: Ninety-one prescriptions were studied, the majority from the clinical haematology department 17.6% (n=16), digestive surgery unit 13.2% (n=12) and pneumology unit 10.98% (n=10). Medication was, in most cases, prescribed by medical residents 94.5% (n=86). Indications included nosocomial pneumonia 39.5% (n=36), febrile neutropaenia 22% (n=20) and digestive infections 17.6% (n=16). Isolated germs were mainly staphylococci (aureus, epidermidis) 25.3% (n=23), Escherichia coli 11% (n=10) and Pseudomonas aeruginosa 11% (n=10). Microbiological documentation was not always available 75.8% (n=69), nor was information on the performance of an antibiogram 60.2% (n=56). The mean dose was 12.7 g/day (eight; 16 g/day) and the mean duration of piperacillin-tazobactam treatment was 12 days (2 days; 55 days). CONCLUSION: This work highlights abidance by dose, treatment duration and indications. However, it also reveals insufficient microbiological documentation, few antibiograms and a lack of antibiotic therapy reassessment. The results of this study have been presented to the Anti-Infective Committee and hospital prescribers in order to improve the proper use of this antibiotic. REFERENCES AND/OR ACKNOWLEDGEMENTS: 1. European Centre for Disease Prevention and Control2015. 2. National network of prevention infections associated with care2015. No conflict of interest