14 research outputs found
SYBR®Green qPCR Salmonella detection system allowing discrimination at the genus, species and subspecies levels
No full textIn this work, a three-level Salmonella detection system based on a combination of seven SYBR®Green qPCR was developed. This detection system discriminates Salmonella at the genus, species and subspecies levels using a single 96-well plate. The SYBR®Green qPCR assays target the invA, rpoD, iroB and safC genes, as well as the STM0296 locus, putatively coding for a cytoplasmic protein. This study includes the design of primer pairs, in silico and in situ selectivity, sensitivity, repeatability and reproducibility evaluations of the seven SYBR®Green qPCR assays. Each detection level displayed a selectivity of 100 %. This combinatory SYBR®Green qPCR system was also compared with three commercially available Salmonella qPCR detection kits. This comparison highlighted the importance of using a multi-gene detection system to be able to detect every target strain, even those with deletion or mutation of important genes. © 2013 The Author(s)
NormAntibio : centre régional de conseil en antibiothérapie « Made in Normandie »
No full textInternational audienc
Late delivery of antibiotics: a new proxy for antimicrobial stewardship?
No full textInternational audienceOBJECTIVES: To analyse the time elapsed between the prescription of antibiotics and their pick-up at the pharmacy and identify their determinants. METHODS: We used the National Health Insurance reimbursement databases on antibiotics delivery in 2021 in La Manche, Western France. Delayed delivery was defined as the time between prescription and antibiotic pick-up of >24 hours. RESULTS: We enrolled 207 250 prescriptions, of whom 18 728 (9.0%) collected their antibiotics at the community pharmacy >24 hours after prescription. Independent factors associated with delayed delivery were age >15 years (15-64 years: OR, 2.08 [1.98-2.19]; p < 0.001 and >65 years OR, 3.27 [3.09-3.46]; p < 0.001), male sex (OR, 00.77 [0.75-0.80]; p < 0.001), low income (OR, 1.08 [1.02-1.15]; p = 0.013), chronic diseases (OR, 1.29 [1.25-1.34]; p < 0.001), prescription during the weekend (OR, 1.49 [1.43-1.56]; p < 0.001), summer season (OR, 1.11 [1.07-1.16]; p < 0.001), lock-down period (OR, 4.15 [3.80-4.53]; p < 0.001), and distance from the patient home to his general practitioner office and the pharmacy >10 km (OR, 1.17 [1.13-1.21]; p < 0.001). DISCUSSION: The delayed delivery of antibiotics after prescription is not uncommon, especially in elderly patients, those with low income or chronic diseases, in case of weekend prescriptions, summer season and when the pharmacy is > 10 km away from the patient’s home and his general practitioner office. If confirmed, this potential indicator of unnecessary prescriptions, readily available in some databases, may be used to target antimicrobial stewardship programmes and monitor the effect of interventions
Evaluation of antibiotic treatment initiation and duration practices in primary care. Cross-sectional study in two French multi-professional health centers
No full textEvaluation of antibiotic treatment initiation and duration practices in primary care. Cross-sectional study in two French multi-professional health centers.
No full textAntibiotic resistance poses a significant human and economic burden. In France, which ranks among the highest consumers of antibiotics in Europe, 93% of prescriptions are issued in primary care, primarily for respiratory tract infections. It is crucial to limit both the indications and the duration of antibiotic prescriptions, with recently updated recommendations in France aimed at achieving this goal. Our main objective was to evaluate whether general practitioners' antibiotic initiation and prescription durations for respiratory infections align with these recommendations. In this prospective cross-sectional study conducted over six weeks in two multi-professional health centers, all consultations for respiratory infections (in both adults and children) documented in patients' medical records were reviewed. Overall, 46.8% (N = 334/714) of consultations resulted in an antibiotic prescription (15.8% for nasopharyngitis and 83.5% for acute cough and bronchitis). Compliance with recommended antibiotic durations was observed in 66.7% (N = 476/714) [95% CI: 63.1%-70.0%] of consultations, with adherence rates exceeding 80% for nasopharyngitis and pharyngitis but falling below 20% for community-acquired pneumonia and acute cough and bronchitis. In total, 1,194 excess days of antibiotic therapy were identified, with an average excess of 1.7 days per prescription [95% CI: 1.4-1.9]. There remains significant room for improvement in both reducing the initiation of antibiotic treatments and shortening their prescribed durations. Managing acute coughs and bronchitis continues to be one of the key challenges in primary care. For nasopharyngitis, the high frequency of this condition translates into potentially large prescribing volumes on a collective scale. Efforts to promote the new paradigm of "shorter is better" for antibiotic prescription durations need to be intensified
Excessive prescription duration is a major contributor of inappropriate antibiotic use in primary care
No full textInternational audienceObjectives: In France, 75% of systemic antibiotics are prescribed by general practitioners (GPs) in primary care. We aimed to estimate the burden of inappropriate use related to excessive prescription duration. Patients and methods: In 2021, we performed a cross-sectional and pharmaco-economic study of a network of six GPs. The references for optimal durations were those of the French national guidelines for antibiotic prescription. Results: Out of 196 antibiotic prescriptions, 33.7 % were of excessive duration, with a mean excess of 0.9 [0.86-0.94] to 1.6 [1.45-1.72] days per prescription. Ear, nose, and throat, respiratory tract, and skin and skin structure infections were the main infections associated with excessive prescription. The pharmaco-economic analysis showed that the cost of excessive prescription duration would range from an estimated 151 to 262 million <euro> in France in 2021. Conclusion: Addressing excessive antibiotic prescription duration by GPs may represent a powerful and cost- saving tool in antimicrobial stewardship programs
Holistic analysis of the determinants of antibiotic prescription in primary care in France: a cross-sectional study with nationwide panel data
No full textInternational audienceOBJECTIVES: Antimicrobial resistance (AMR) is a critical public health issue, with overuse of antibiotics being a key driver. This study aimed to examine the determinants of antibiotic prescription in primary care in France, using nationwide panel data from 2022. METHODS: Data were obtained from several open sources. Antibiotic consumption was measured by the number of prescriptions of all systemic antibiotics per 1000 inhabitants, and patient, physician, healthcare system and seasonal viral outbreak (influenza and COVID-19) were considered as potential related factors. We then performed a linear multivariate regression model. RESULTS: The main findings were that patients <15 years (β = 7.36, P < 0.001), females (β = 9.54, P = 0.01), those with chronic diseases (β = 16.29, P < 0.001), white-collar workers (β = 3.40, P < 0.001) and European Deprivation Index score (β = 4.19, P < 0.001) had higher antibiotic prescription rates. Older physicians (age > 50 years: β = 1.35, P < 0.001) and those practising in areas with higher healthcare accessibility (Local Potential Accessibility score: β = 40.93, P < 0.001) were also associated with higher prescription volumes. In contrast, female physicians were linked to lower prescription rates (β = -0.62, P = 0.002). CONCLUSIONS: The study emphasizes the complexity of antibiotic prescription behaviours, showing that both clinical and non-clinical factors contribute to prescription patterns. It also highlights social and accessibility factors as significant drivers of antibiotic use. In order to be effective, strategies for the correct use of antibiotics must account for these different aspects
General practitioners' clinical practice on the management of cystitis in Normandy, France: A clinical vignettes‐based study
No full textMorbidity and mortality related to pneumonia and TRACHEOBRONCHITIS in ICU after lung transplantation
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