En quoi le clinicien contribue-t-il à l’amélioration de la qualité de l’antibiothérapie ?

Abstract

The main factors on which the antibiotic policy measures are based, are an increasing cost of antimicrobial drug consumption in hospitals, reports of inappropriate antibiotic use, and increase in bacterial resistance. Physicians play a central role in determining the safety, efficacy, and efficiency of antibiotic use. Guidelines to optimize the use of antimicrobial agents in hospitals have been recommended including several methods such as using antibiotic order forms, automatic stop orders, rotation and restricted use of antibiotics, monitoring of use and specific audits, cycling. Education is not sufficient as a single strategy to improve the quality and combination of both restrictive and educational measures. Intervention strategies are required to improve overall antibiotic use in hospitals. Computer-assisted prescribing may help physicians to improve antibiotic choices when prescribing and to check the validity of prescriptions according to local guidelines and epidemiology of bacterial resistance. The intervention of infectious diseases specialists is significantly associated with improved use of antibiotics. Setting-up teams, including an infectious diseases physician, a pharmacist, and a clinical microbiologist is efficient to select antimicrobial agents, to provide expert counseling, and to organize educational programs.