PIN12: IMPLICATIONS OF APPLYING DIFFERENT NATIONAL GUIDELINES ADDRESSING SURGICAL ANTIBIOTIC PROPHYLAXIS: A CROSS SECTIONAL STUDY OF 386 PATIENTS UNDERGOING TOTAL HIP REPLACEMENT SURGERY

Presentation at the 7th annual Forum for Development Cooperation with Indigenous Peoples, which commenced the 5th-6th of October 2006. The Centre for Sámi Studies hosted the conference at the University of Tromsø, Norway. Full conference report available at http://hdl.handle.net/10037/2996</a

Risk of surgical site infection and efficacy of antibiotic prophylaxis: a cohort study of appendectomy patients in Thailand

BACKGROUND: No data currently exist about use of antibiotics to prevent surgical site infections (SSI) among patients undergoing appendectomy in Thailand. We therefore examined risk factors, use, and efficacy of prophylactic antibiotics for surgical site infection SSI among patients with uncomplicated open appendectomy. METHODS: From July 1, 2003 to June 30, 2004 we conducted a prospective cohort study in eight hospitals in Thailand. We used the National Nosocomial Infection Surveillance (NNIS) system criteria to identify SSI associated with appendectomy. We used logistic regression analysis to obtain relative risk estimates for predictors of SSI. RESULTS: Among 2139 appendectomy patients, we identified 26 SSIs, yielding a SSI rate of 1.2 infections/100 operations. Ninety-two percent of all patients (95% CI, 91.0–93.3) received antibiotic prophylaxis. Metronidazole and gentamicin were the two most common antibiotic agents, with a combined single dose administered in 39% of cases. In 54% of cases, antibiotic prophylaxis was administered for one day. We found that a prolonged duration of operation was significantly associated with an increased SSI risk. Antibiotic prophylaxis was significantly associated with a decreased risk of SSI regardless of whether the antibiotic was administered preoperatively or intraoperatively. Compared with no antibiotic prophylaxis, SSI relative risks for combined single-dose of metronidazole and gentamicin, one-day prophylaxis, and multiple-day antibiotic prophylaxis were 0.28 (0.09–0.90), 0.30 (0.11–0.88) and 0.32 (0.10–0.98), respectively. CONCLUSION: Single-dose combination of metronidazole and gentamicin seems sufficient to reduce SSIs in uncomplicated appendicitis patients despite whether the antibiotic was administered preoperatively or intraoperatively

Pharmacie clinique dans le domaine des dispositifs médicaux : définition et enjeux.

International audienc

Pharmacie clinique et dispositifs médicaux

International audienc

La pharmacie clinique en milieu hospitalier : une enquête de satisfaction auprès des prescripteurs

Introduction: The purpose of the study was to evaluate physician's satisfaction with the clinical pharmacy activities in a French regional hospital. Methods: Data were collected by face-to-face interviews carried out by a public health intern with physicians from 14 different departments of medicine and surgery. A specifically designed questionnaire was used for this study. This contained 18 closed-ended questions, 3 open-ended questions and 6 questions relating to the multidisciplinary analysis of prescriptions of elderly patients. Results: The questionnaire was proposed to 78 physicians, of which 62 replied (participation rate of 79%). Thirty-seven percent were interns (23/62), 19% were assistants (12/62) and 44% were senior physicians (27/62). Clinical pharmacy satisfaction levels were generally very high. In regard to clinical skills, 87% of the physicians were satisfied with pharmacists' competencies and 91% by the pertinence of transmitted information. Ninety-five percent of the physicians were also satisfied by the logistical aspect and the relationship with pharmacists (reactivity, availability and communication). Analysis of the open-ended questions showed that physicians were in favour of the increased presence of clinical pharmacists on the wards. Conclusions: This study shows a high level of physician satisfaction in relation to the clinical pharmacy activities in our hospital, and should be viewed as a strong endorsement of the work of the clinical pharmacy. This study highlights some areas of improvement such as increase presence of the clinical pharmacists on the wards. In order to assess periodically our activity, this study must be repeated in the future.Objectifs: L’objectif de cette étude était d’évaluer la satisfaction des prescripteurs par rapport à l’activité de pharmacie clinique déployée dans un centre hospitalier régional français. Méthodes: Une interview en face à face a été réalisée par un interne de santé publique auprès des prescripteurs de 14 services de médecine et de chirurgie. Un questionnaire, spécifiquement conçu pour l’étude et composé de 18 questions fermées, de 3 questions ouvertes et de 6 questions portant sur l’analyse pluridisciplinaire des ordonnances du sujet âgé a été utilisé. Résultats: Soixante dix-neuf pour cent des prescripteurs sollicités ont accepté de répondre au questionnaire (62/78) dont 37 % d’internes (23/62), 19 % d’assistants (12/62) et 44 % de praticiens hospitaliers (27/62). La satisfaction générale vis-à-vis de la pharmacie clinique est bonne. Au niveau clinique, 87 % des prescripteurs se disent satisfaits de l’apport de compétences de la part du pharmacien et 91 % par la pertinence des informations transmises. Quatre-vingt quinze pour cent des prescripteurs sont également satisfaits de l’aspect logistique et relationnel (réactivité, disponibilité, communication). L’analyse des questions ouvertes met en évidence une demande de renforcement de la présence pharmaceutique en unités de soins de la part les prescripteurs. Conclusions: Cette enquête montre une satisfaction importante de la part des prescripteurs vis-à-vis de l’activité de pharmacie clinique déployée et constitue un encouragement fort pour la poursuite du déploiement de cette activité. Elle dégage également des axes d’amélioration comme le renforcement de la présence pharmaceutique en unités de soins. Dans l’optique d’une démarche d’évaluation continue, cette enquête devra être répétée dans le futur.</p

Quoi de neuf dans le traitement de l’hypertension artérielle pulmonaire en 2015 ?

International audienceL’hypertension artérielle pulmonaire (HTAP) est une maladie vasculaire pulmonaire rare et grave, caractérisée par l’augmentation progressive des résistances artérielles pulmonaires, qui peut conduire, à terme, à une insuffisance cardiaque droite et au décès. En 2015, on dispose de dix molécules enregistrées dans cette indication correspondant à plusieurs centaines de patients inclus dans le monde dans des essais de phases II et III au cours de ces vingt dernières années, véritable [...