Gestion de services, tarification à l’activité, recherche clinique et évaluation des pratiques professionnelles : un même outil informatique

Roger, P. M.; Farhad, R.; Leroux, Stéphanie; Rancurel, S.; Licari, M.; Bellissimo, R.; Cua, Éric

doi:10.1016/j.medmal.2008.06.027

Cited by 18 publications

(5 citation statements)

References 5 publications

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“…The medical dashboard of our ward records prospectively 28 characteristics of each hospitalization including hospitalization motive, final diagnosis, comorbidities, microbiological data including blood culture and all antibiotics prescribed [10]. Patients are classified regarding the site of infection; in case of bacteremia without any organ infection detected they are included in the BUO group.…”

Section: Methodsmentioning

confidence: 99%

Patients with community-acquired bacteremia of unknown origin: clinical characteristics and usefulness of microbiological results for therapeutic issues: a single-center cohort study

Courjon

Demonchy

Degand³

et al. 2017

Ann Clin Microbiol Antimicrob

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Bacteremia of unknown origin (BUO) are associated with increased mortality compared to those with identified sources. Microbiological data of those patients could help to characterize an appropriate empirical antibiotic treatment before bloodcultures results are available during sepsis of unknown origin. Based on the dashboard of our ward that prospectively records several parameters from each hospitalization, we report 101 community-acquired BUO selected among 1989 bacteremic patients from July 2005 to April 2016, BUO being defined by the absence of clinical and paraclinical infectious focus and no other microbiological samples retrieving the bacteria isolated from blood cultures. The in-hospital mortality rate was 9%. We retrospectively tested two antibiotic associations: amoxicillin–clavulanic acid + gentamicin (AMC/GM) and 3rd generation cephalosporin + gentamicin (3GC/GM) considered as active if the causative bacteria was susceptible to at least one of the two drugs. The mean age was 71 years with 67% of male, 31 (31%) were immunocompromised and 52 (51%) had severe sepsis. Eleven patients had polymicrobial infections. The leading bacterial species involved were Escherichia coli 25/115 (22%), group D Streptococci 12/115 (10%), viridans Streptococci 12/115 (10%) and Staphylococcus aureus 11/115 (9%). AMC/GM displayed a higher rate of effectiveness compared to 3GC/GM: 100/101 (99%) vs 94/101 (93%) (p = 0.04): one Enterococcus faecium strain impaired the first association, Bacteroides spp. and Enterococcus spp. the second. In case of community-acquired sepsis of unknown origin, AMC + GM should be considered.

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Section: Methodsmentioning

confidence: 99%

Patients with community-acquired bacteremia of unknown origin: clinical characteristics and usefulness of microbiological results for therapeutic issues: a single-center cohort study

Courjon

Demonchy

Degand³

et al. 2017

Ann Clin Microbiol Antimicrob

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“…Indeed, in this study the inclusion of patients included until December 2011 and previous studies precedents shows that our DB avoids these three pitfalls [4,5].…”

Section: Should Antibiotic Therapy Be Adapted To the Diagnosis (Acutementioning

confidence: 77%

“…The required data comes from hospitalization reports, which were systematized according to a consensual pattern. The exact definition of hospitalization causes and final diagnosis, extracted from these reports, validated by the senior infectious diseases specialist managing the patient, is classified in categories defined by site of the infection, constituting as many homogeneous groups of hospital stay [4].…”

Section: Methodsmentioning

confidence: 99%

“…The dermatologic infectious diseases account for 9.5% of patients hospitalized in our infectious diseases unit all etiologies included [4], or 820 patients in 6.5 years of recording in our DB. Among these patients, 42% present with erysipelas and ADH.…”

Section: Should the Concept Of "Cellulitis" Be (Re-) Introduced Consementioning

confidence: 99%

“…We set up a dashboard (DB) of medical activity in our unit allowing a rapid PPA [4]. The consecutive analyses made with this DB contribute to real time evaluation of our therapeutic practices [5].…”

mentioning

confidence: 99%

See 2 more Smart Citations

Cutaneous infections, good use of antibiotics and diagnostic accuracy

Roger¹,

Risso²,

Salvador³

et al. 2012

Médecine et Maladies Infectieuses

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Antibiotics-related adverse events in the infectious diseases department of a French teaching hospital: a prospective study

Courjon

Pulcini

Cua

et al. 2013

Eur J Clin Microbiol Infect Dis

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Antibiotics are a significant cause of adverse events (AE), but few studies have focused on prescriptions in hospitalized patients. In infectious diseases departments, the high frequency and diversity of antibiotics prescribed makes AE post-marketing monitoring easier. The aim of our study was to assess the incidence and type of AE in the infectious diseases department of a French teaching tertiary-care hospital. The main characteristics of each hospitalization, including all antibiotics prescribed and any significant AE were recorded prospectively in the medical dashboard of the department. We included all patients having suffered an AE due to systemic antibiotics between January 2008 and March 2011. Among the 3963 hospitalized patients, 2682 (68%) received an antibiotic and 151/2682 (5.6%) suffered an AE. Fifty-two (34%) AE were gastrointestinal disorders, 32 (21%) dermatological, 20 (13%) hepatobiliary, 16 (11%) renal and urinary disorders, 13 (9%) neurological and 11 (7%) blood disorders. Rifampin, fosfomycin, cotrimoxazole and linezolid were the leading causes of AE. Sixty-two percent of the antibiotics causing an AE were stopped and 38% were continued (including 11% with a dose modification). Patients suffering from AE had an increased length of stay (18 vs 10 days, P < 0.001). Our data could help choosing the safest antibiotic when several options are possible.

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Gestion de services, tarification à l’activité, recherche clinique et évaluation des pratiques professionnelles : un même outil informatique

Cited by 18 publications

References 5 publications

Patients with community-acquired bacteremia of unknown origin: clinical characteristics and usefulness of microbiological results for therapeutic issues: a single-center cohort study

Patients with community-acquired bacteremia of unknown origin: clinical characteristics and usefulness of microbiological results for therapeutic issues: a single-center cohort study

Cutaneous infections, good use of antibiotics and diagnostic accuracy

Antibiotics-related adverse events in the infectious diseases department of a French teaching hospital: a prospective study

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