Bacteriological analysis of urinary tract infections found in a French nursing home

Bacteriological analysis of urinary tract infections found in a French nursing home. Establishment of an empiric antibiotic therapy protocol

INTRODUCTION

S. LAFARGUE1, B BERNADAC2, J.L. PIROT3, H. RAIMBAULT 4, E. SASSOT5, F. DELAMARRE-DAMIER6

(1) MD CMD EHPAD Mer et Pins Saint Brevin, Agree Member, France,
(2) Pharm D GCS Pays de Retz, France,
(3) MD biological lab Saint Brevin les pins France,
(4) MD, Saint Brevin Nursing Home France,
(5) Emmanuelle SASSOT, NP, EHPAD Mer et Pins,
(6) MD MBA CMD Cholet Hospital France, Saint Laurent sur Sèvre Nursing Home and Viellevigne Nursing Home on behalf of AGREE French Nursing Home Research Organization Chateau Thebaud France

Bacterial infections are common in the elderly. They are the third leading cause of death in France (1). The prevalence of infections in nursing homes (NH) varies between 1.6 and 32.7%(2) and for Urinary tract infections (UTI) the prevalence is 40% (3). Elderly people in institutions receive 2 times more antibiotics than at home (4). Urinary colonization has a high prevalence in the elderly : risk increases with age, female gender and dependence (20 to 50%) (5). Treatment of urinary colonization may lead to emergence and spread of antibiotic-resistant bacteria. The aim of this study is to adapt the French infectious diseases recommendations (SPILF) (6) to the nursing home bacterial ecology wich receive 310 elderly people. The fight against infectious risk in nursing homes requires a better control of the bacterial ecology. Knowledge of urinary germ resistance patterns allowed us to develop an adapted antibiotic protocol.

 

Télécharger ce poster (pdf)

 

 

Ofloxacin-induced fulminant hepatitis : a case report

Ofloxacin-induced fulminant hepatitis : a case report

INTRODUCTION

C. JOYAU1, G. VEYRAC1, A. DEININGER2, L. TRIQUET3, F. DELAMARRE-DAMIER4, P. JOLLIET1,5
(1) Clinical Pharmacology Department, Biology Institute, University Hospital, Nantes, France ;
(2) Pharmacy, Saint Nazaire Hospital, Saint Nazaire, France ;
(3) Department of Pharmacovigilance Center, Pontchaillou University Hospital, Rennes, France ;
(4) Coordinating physician of nursing home «Montfort», Saint Laurent sur Sèvre, France and Hospital Practioner, Cholet Hospital, France ;
(5) EA 4275 «Biostatistics, Pharmacoepidemiology and Subjectives Health Measures», Medicine University, Nantes


Fluoroquinolones (FLQ) are synthetic antibiotics widely used for treatment of bacterial infections in elderly patients. The profile of adverse effects consists of headache, dizziness, seizures, confusion, diplopia, peripheral neuropathy, photosensibility, tendinopathy, kidney failure, pseudomembranous colitis, psychiatric effects. FLQ are also known to cause liver enzymes increase. Indeed, the FLQ may be responsible for liver disorders ranging from asymptomatic elevated liver enzymes to fulminant hepatitis responsible for death. This hepatotoxicity is considered as a class effect of FLQ. Fulminant hepatitis is a side effect reported in the summary of products characteristics of some FLQ,
In European database of suspected adverse drug reactions reports (Eudravigilance), 67 cases of fulminant hepatitis are reported with FLQ: 8 fatal cases with ofloxacin, 12 cases with ciprofloxacin (including 9 deaths), 32 cases with levofloxacin (including 19 deaths) and 15 cases with moxifloxacin (including 12 deaths).
We report a fatal case of a patient treated with ofloxacin who developed fulminant hepatitis.

 

Télécharger ce poster (pdf)

 

 

Plus d'articles...

  1. Identification and comparison of rates of inappropriate drugs in elderly population
  2. Drug-induced taste disorders : analysis of prescriptions of patients living in two nursing homes in France
  3. Impact of the Bio Psycho Social (BPS) assessment in nursing home organisation
  4. Etat des lieux de la prise en charge médicamenteuse de l’hypertension artérielle de la personne âgée