Evaluation of broad-spectrum beta-lactam prescriptions (except carbapenems) in a French teaching hospital.

Abstract Objectives We aimed to assess broad-spectrum beta-lactam prescriptions (except carbapenems) in a French teaching hospital and the impact of controlled dispensing, antimicrobial management team, and antibiotic treatment reassessment on Day 2–3. Patients and methods We performed a point-prevalence study in all hospital units and analyzed curative antibiotic broad-spectrum beta-lactam prescriptions. The assessment focused on indication, dosing, combinations, revaluation on Day 2–3, and treatment duration. Results Sixty-seven broad-spectrum beta-lactam prescriptions were identified. The main prescriptions were amoxicillin-clavulanic acid (37%, n  = 25), ceftriaxone (36%, n  = 24), and piperacillin-tazobactam (16%, n  = 11). Indications, doses, combinations, and reassessment on Day 2–3 were appropriate, respectively 90% ( n  = 60), 96% ( n  = 64), 94% (33/35 combinations), and 88% ( n  = 59). However, appropriate treatment durations amounted to only 63% ( n  = 42). The benefit of controlled dispensing was observed in terms of overall antibiotic treatment duration: 86% versus 51% adequacy for uncontrolled dispensing of beta-lactams ( P  = 0.02). The antimicrobial management team improved the antibiotic treatment duration: 73% of appropriate durations versus 44% for beta-lactams not monitored by the team, but this difference was not significant. Conclusion Broad-spectrum beta-lactams were usually well prescribed but the adequacy of treatment duration could be improved, especially by reinforcing the monitoring of prescriptions.