Skip to Main content Skip to Navigation
Theses

Evaluation de l'impact d'une équipe opérationnelle en infectiologie sur la consommation et le coût des antibiotiques au CHU de Nancy : essai d'intervention contrôlé

Abstract : Overuse and inappropriate use of antibiotics has been described worldwide for about 25 years, in both community and hospital settings. In addition to its deleterious effect on patients, antibiotic misuse can lead to the emergence of bacterial resistance and increased the cost of hospitalization. Indeed, during the 1990s several organizations published plans to control the costs of antibiotics and limit selective pressure on microorganisms through surveillance and interventions promoting rational use. An antimicrobial policy has been implemented at the University Hospitals of Nancy since the mid-1990s. This antibiotic policy was therefore reinforced the beginning of 2006, changes included complete reorganization of the methods of prescribing and delivering antibiotics in all wards of the University hospitals of Nancy. In addition, an Operational Multidisciplinary Antibiotic Team (OMAT) including an infectious disease physician and a clinical pharmacist was established in some wards. To evaluate the effectiveness of this OMAT, in reducing the hospital antimicrobial consumption and costs a cluster controlled "before-after" study was performed. We compared consumption of antibiotics overall and by therapeutic class and cost savings between "before" and "after" in both groups (control and intervention). The results of this study have shown that overall consumption of antibiotics decreased after implementation of the OMAT by 34% in the intervention group and by 3% in the control group (p = 0.003). For the same activity, the total cost savings were 14-fold higher in the intervention group. Establishment of an operational multidisciplinary team may be an effective way to reduce hospital antibiotic use and cost.
Document type :
Theses
Complete list of metadata

Cited literature [217 references]  Display  Hide  Download

https://hal.univ-lorraine.fr/tel-01746235
Contributor : Thèses Ul <>
Submitted on : Thursday, March 29, 2018 - 10:28:26 AM
Last modification on : Tuesday, October 13, 2020 - 10:46:05 AM
Long-term archiving on: : Thursday, September 13, 2018 - 11:59:31 AM

File

SCD_T_2011_0076_BEVILACQUA.pdf
Files produced by the author(s)

Identifiers

  • HAL Id : tel-01746235, version 1

Citation

Sibylle Bevilacqua. Evaluation de l'impact d'une équipe opérationnelle en infectiologie sur la consommation et le coût des antibiotiques au CHU de Nancy : essai d'intervention contrôlé. Médecine humaine et pathologie. Université Henri Poincaré - Nancy 1, 2011. Français. ⟨NNT : 2011NAN10076⟩. ⟨tel-01746235⟩

Share

Metrics

Record views

313

Files downloads

895