OHP-045 Impact of a Multidisciplinary Staff Meeting on Antibiotic Treatment Quality For Osteoarticular Infections in an Orthopaedic Surgery Care Unit

Abstract

Background Treating osteoarticular infections is difficult. Purpose To evaluate professional practise, we studied the effect of a multidisciplinary staff meeting on the quality of antibiotic treatment in an orthopaedic surgery care unit. Materials and Methods Via the coding process, we retrospectively studied patients hospitalised for osteoarticular infections (diabetic foot excluded) in the orthopaedic care unit of a general hospital in France. We compared antibiotic treatment conformity to good practise (bacteriology, dose, length of treatment, time taken to implementing microbiology report), length of hospitalisation and 6 month-outcome, for patients with osteoarticular infections, before (March 2007 to March 2009) and after (March 2009 to March 2011).implementation of the multidisciplinary staff meeting. Results85 patients were selected and 77 files were examined. Fifty-five medical records were actively devoted to osteoarticular infection and all of them were analysed: this worked out at 30 patients (32 infections) before the staff meetings and 26 patients (28 infections) after the staff meetings had started. Staff meeting decisions were reported in medical files in 72% of cases. Before staff meetings were instituted, antibiotic treatment was changed in 47% of cases, versus 96% since establishment of the staff meeting (p < 0.0001). Dose was optimum in 72% of infections before staff meetings were instituted, versus 89% afterwards (P = 0.11) and length of antibiotic treatment conformed to recommendations in 41% of infections before staff meetings, versus 86% after staff meetings had begun (P = 0,0005). The average time to respond to an antibiogram decreased from 2 days before staff meetings to 1.7 days after staff meeting (P = 0.43), and length of hospitalisation was 19.8 days before staff meetings versus 23.1 days after (P = 0.49). Recovery at 6 months accounted for 62% of patients before staff meetings, versus 76% after staff meetings (P = 0.35) and failure at 6 months concerned 29% of infections before staff meetings versus 24% after their institution (P = 0.75). Conclusions Since the beginning of multidisciplinary staff meeting in our orthopaedic surgery care unit, antibiotic treatment has significantly improved concerning spectrum and duration of treatment (p ≤ 0.0005). With this limited sample, clinical impact at 6 months was not significant. No conflict of interest.