Audit on antibiotic prescriptions in a department of infectious diseases

Objectives France is one of the countries that prescribe the most antibiotics. The inappropriate use of antibiotics participates in the emergence of multi-resistant bacteria. This study was aimed at assessing the adequation of antibiotic prescriptions in a hospital department of internal medicine-infectious diseases. Methods Over a two-month period, all the antibiotics treatments were analysed prospectively. The adequation of the treatments was analysed at first with regard to the various consensus conferences of the French-speaking Society of infectious diseases (Societe de pathologie infectieuse de langue francaise (Spilf)) and then with regard to the bacteriological results. Results One hundred and five prescriptions were analysed during the study period. Thirty-five percent of prescriptions were inadequate with regard to the criteria used. In 22 cases the prescription was excessive, in 8 cases it was unjustified and in 5 cases it was inappropriate. Moreover, in univariate analysis, 3 factors were correlated with inadequation: prescriptions drawn-up by a non-infectious disease practitioner (OR = 3.45, IC 95 % 1.34-9.09, p =0.008), prescriptions drawn-up by junior in the department (OR =4.10, IC 95 % 1.54 -11.08, p =0.003) and prescriptions pour respiratory infections (OR = 2.58, IC 95 % 1.03-6.48, p =0.04). Conclusion This study conducted in a department of infectious diseases reveals the persisting high rate of inappropriate prescriptions, confirming the need to develop control and retro-control strategies regarding the prescription of antibiotics in order to control the diffusion of multi-resistant bacteria.