Evaluation of antibiotic curative treatments in a French orthopedic surgery unit

Introduction. - The aim of this study was to evaluate the technical quality and the relevance of antibiotics used in an orthopedic unit. Design. - A prospective and descriptive assessment was made of patients hospitalized in the orthopedic surgery department of our general hospital, receiving antimicrobial therapy. The relevance of antibiotics was evaluated using as a reference local guidelines previously validated by the antibiotics committee. Result. - During the period of study, 37 of the 249 hospitalized patients received antibiotics (14.9 %). The reasons for hospitalization were mainly lower limb trauma (38%) and an infectious disease (35 %). Hospital-acquired infections accounted for 16.2 % of antibiotic prescriptions. During the study, we observed that the dose regimen was inappropriate in 9% of the cases, that the expected length of treatment was not indicated (76 %), and that the mode of administration was not mentioned in 8 % of the cases. Twenty five percent of combinations were not relevant. Finally, 27.3 % of prescriptions were not in conformity with guidelines. Conclusions -. The quality and relevance of antibiotics used as curative treatments in the orthopedic surgery unit seem satisfactory for the dose regimen, the route and dose of administration and combinations used. We identified a few points which need to be improved: update and improvement of local antibiotherapy guidelines, promotion of training sessions for new prescribers in the institution. (C) 2009 Elsevier Masson SAS. All rights reserved.