[Adequacy of antibiotic therapy to guidelines for urinary tract infection in hospital]

N. Saurel (1) , P. Pavese (2) , L. Boyer (1) , J.-P. Vittoz (1) , C. Decouchon (2) , L. Foroni (3) , M. Maurin (4, 5) , P. François (1) , J.-P. Stahl (2)

1 Service de qualitique et d'évaluation médicale
2 Service des Maladies Infectieuses
3 UGA UFRP - Université Grenoble Alpes - UFR Pharmacie
4 Laboratoire de Bactériologie
5 LAPM - Laboratoire Adaptation et pathogénie des micro-organismes [Grenoble]

OBJECTIVE: We estimated the adequacy of antibiotic therapy to guidelines for nosocomial and community-acquired urinary tract infections in hospital. DESIGN: For 4 weeks, all adult patients hospitalized with positive bacteriuria were included in our retrospective study. Data was collected from urine culture results and from patient medical files. Adequacy to guidelines was analyzed by two infectious disease specialists, focusing on the indication, antibiotic choice, dosage, route of administration, and duration of treatment. RESULTS: Overall 202 patients were enrolled in the study (63.9% women). The decision of initiating or not antibiotic therapy was appropriate in 66.8% of cases. Antibiotherapy indication and antibiotic choice were adequate in 94 cases in empiric prescription (50.8%) and in 123 cases (60.9%) after receiving culture antibiogram results. Route of administration was adequate in 94.4% and dosage in 70.8% of prescriptions. This poor compliance with guidelines was mainly due to unnecessary prescriptions in asymptomatic bacteriuria, unnecessary biotherapies and spectrum errors. CONCLUSIONS: It seems important to remind prescribers of recommendations for urinary tract infections.

Domaines: Biochimie, Biologie Moléculaire

N. Saurel, P. Pavese, L. Boyer, J.-P. Vittoz, C. Decouchon, et al.. [Adequacy of antibiotic therapy to guidelines for urinary tract infection in hospital]. Médecine et Maladies Infectieuses, 2006, 36 (7), pp.369-74. ⟨10.1016/j.medmal.2006.02.004⟩. ⟨hal-00171700⟩