Antibiotics are a significant cause of adverse events (AE), but few studies have focused on prescriptions in hospitalized patients. In infectious diseases departments, the high frequency and diversity of antibiotics prescribed makes AE post-marketing monitoring easier. The aim of our study was to assess the incidence and type of AE in the infectious diseases department of a French teaching tertiary-care hospital. The main characteristics of each hospitalization, including all antibiotics prescribed and any significant AE were recorded prospectively in the medical dashboard of the department. We included all patients having suffered an AE due to systemic antibiotics between January 2008 and March 2011. Among the 3963 hospitalized patients, 2682 (68%) received an antibiotic and 151/2682 (5.6%) suffered an AE. Fifty-two (34%) AE were gastrointestinal disorders, 32 (21%) dermatological, 20 (13%) hepatobiliary, 16 (11%) renal and urinary disorders, 13 (9%) neurological and 11 (7%) blood disorders. Rifampin, fosfomycin, cotrimoxazole and linezolid were the leading causes of AE. Sixty-two percent of the antibiotics causing an AE were stopped and 38% were continued (including 11% with a dose modification). Patients suffering from AE had an increased length of stay (18 vs 10 days, P < 0.001). Our data could help choosing the safest antibiotic when several options are possible.

译文

:抗生素是造成不良事件(AE)的重要原因,但很少有研究关注住院患者的处方。在传染病部门,处方抗生素的频繁性和多样性使AE上市后监测更加容易。我们研究的目的是评估法国一家三级教学医院的传染病科的AE的发生率和类型。每次住院的主要特征,包括所有处方的抗生素和任何明显的不良事件,均会在部门的医疗仪表板上进行前瞻性记录。我们纳入了所有在2008年1月至2011年3月之间因全身性抗生素而发生AE的患者。在3963例住院患者中,有2682名(68%)接受了抗生素,而151/2682(5.6%)发生了AE。胃肠疾病有52例(34%)AE,皮肤科有32例(21%),肝胆疾病有20例(13%),肾脏和泌尿系统疾病有16例(11%),神经系统有13例(9%)和11例(7%)血液疾病。利福平,磷霉素,cotrimoxazole和利奈唑胺是AE的主要原因。引起AE的抗生素中有62%停止使用,而38%继续使用(包括11%的剂量调整)。患有AE的患者的住院时间增加了(18天比10天,P <0.001)。如果有几种选择,我们的数据可能有助于选择最安全的抗生素。

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