Evolution of antibiotic treatments for healthcare-associated infections caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae in France - 22/10/22
Highlights |
• | Nationwide study, using data from Point Prevalance studies in acute care hospitals. |
• | Decrease in carbapenem and aminoglycoside use between 2012 and 2017, in patients with an ESBL-producing Enterobacteriaceae HAI: |
• | Treatment durations remain longer than recommended. |
• | Results can serve to direct future efforts in antimicrobial stewardship. |
Abstract |
Background |
Infections caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBLE) remain a public health challenge.
Aim |
We traced the evolution of antibiotics prescribed for patients with ESBLE-healthcare associated infections (ESBLE-HAI) between 2012 and 2017, with a specific focus on treatments for lower urinary tract infections (LUTI).
Methods |
We used the 2012 and 2017 French point prevalence survey data. Patients with ESBLE-HAI were defined as those diagnosed with at least one Enterobacteriaceae with ESBL production. Patients with LUTI caused by ESBLE (ESBLE-LUTI) were defined as those with LUTI as the reported infection site and diagnosed with ESBLE. We only analysed treatments intended for HAI.
Results |
In 2017, more than half of treatments for ESBLE-HAIs were β-lactams. While from 2012 to 2017 the proportion of carbapenem treatments decreased from 30% to 25%, penicillin treatments doubled. Among patients treated for ESBLE-LUTI, a larger proportion received a single antibiotic in 2017. The most frequently prescribed antibiotics for these infections were amoxicillin/clavulanic acid, nitrofurantoin and ofloxacin. More than one out of six treatments lasted for more than 7 days. Carbapenem use was halved between 2012 and 2017, and decreases were likewise observed for aminoglycosides.
Conclusion |
In accordance with French recommendations, comparison of the two most recent French point prevalence surveys showed an evolution in ESBLE-HAI treatment, especially for ESBLE-LUTI. However, treatment durations remained longer than recommended. Data from the 2022 survey should provide insights on the future evolution of prescription trends.
Le texte complet de cet article est disponible en PDF.Keywords : Enterobacteriaceae, Extended-spectrum beta-lactamase, Antibiotics, Point prevalence survey, Healthcare-associated infections
Plan
Vol 52 - N° 7
P. 396-402 - octobre 2022 Retour au numéro
Article précédent
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