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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Strategies of initiation and streamlining of antibiotic therapy in 41 French intensive care units. | Montravers et al. Critical Care 2011 15 R17 http ccforum.eom content 15 1 R17 KS CRITICAL CARE RESEARCH Open Access Strategies of initiation and streamlining of antibiotic therapy in 41 French intensive care units D A I I I k k k k IV I r r 1 2I_I Z A in1 I k z F3 4 D - . c 11 I 71 F5 D ỈF Ỉ r- I . r- r6 I 1 Di M r I D I z-v r 7 A I I I k Z l I8 Philippe Montravers nerve Dupont Remy Gauzit Denon veoer Jean-Pierre Bedos Alain Lepape CIAR Club d infectiologie en Anesthésie-Réanimation Study Group Abstract Introduction Few studies have addressed the decision-making process of antibiotic therapy AT in intensive care unit ICU patients. Methods In a prospective observational study all consecutive patients admitted over a one-month period 2004 to 41 French surgical n 22 or medical medico-surgical ICUs n 19 in 29 teaching university and 12 nonteaching hospitals were screened daily for AT until ICU discharge. We assessed the modalities of initiating AT reasons for changes and factors associated with in ICU mortality including a specific analysis of a new AT administered on suspicion of a new infection. Results A total of 1 043 patients 61 of the cohort received antibiotics during their ICU stay. Thirty percent 509 of them received new AT mostly for suspected diagnosis of pneumonia 47 bacteremia 24 or intraabdominal 21 infections. New AT was prescribed on day shifts 45 and out-of-hours 55 mainly by a single senior physician 78 or by a team decision 17 . This new AT was mainly started at the time of suspicion of infection 71 and on the results of Gram-stained direct examination 21 . Susceptibility testing was performed in 261 51 patients with a new AT. This new AT was judged inappropriate in 58 of these 261 22 patients. In ICUs with written protocols for empiric AT n 25 new AT prescribed before the availability of culture results P 0.003 and out-of-hours P 0.04 was more frequently observed than in ICUs without protocols but the appropriateness of AT was not different. In .
