Clinical benefit of infectious diseases consultation: a monocentric prospective cohort study
- A. de La BlanchardièreAffiliated withInfectious Diseases Unit, University Hospital of Caen Email author
- , J. BoutemyAffiliated withInfectious Diseases Unit, University Hospital of Caen
- , P. ThibonAffiliated withDepartment of Hygiene and Public Health, University Hospital of Caen
- , J. MichonAffiliated withInfectious Diseases Unit, University Hospital of Caen
- , R. VerdonAffiliated withInfectious Diseases Unit, University Hospital of Caen
- , V. CattoirAffiliated withDepartment of Microbiology, University Hospital of Caen
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To determine the association of clinical outcomes with the adherence to Infectious Diseases Consultation (IDC) recommendations.
From March to August 2009, all patients hospitalized in our hospital, for whom an IDC was requested, were prospectively enrolled. The adherence to recommendations was ascertained after 72 h from the IDC. The primary objective of the study was to evaluate the clinical cure rate 1 month after the IDC, according to the adherence to IDC recommendations.
An IDC was requested for 258 inpatients. The infectious disease (ID) was most often non-severe (66 %), community-acquired (62 %), and already under treatment (47 %). IDC proposals were most often formulated via a formal consultation (57 %). Physicians’ adherence to IDC recommendations was 87 % for diagnostic tests and 90 % for antibiotherapy. In the multivariate analysis, severe infections and direct consultation were independently associated with increased odds of adherence to recommendations for performing diagnostic tests (odds ratios 5.4 and 4.0, respectively). The overall clinical cure rate was 84 % and this did not differ according to the adherence to IDC recommendations for diagnostic tests (84.3 vs. 71.4 %, p = 0.15) and antimicrobial treatment (84.8 vs. 77.8 %, p = 0.34).
Some limitations of the study may explain the lack of evidence of a clinical benefit, such as the very high level of adherence to IDC recommendations and the low proportion of severe infections. However, clinical improvement was always better when recommendations were followed. Therefore, further larger randomized multicentric studies including more patients suffering from more severe IDs may be needed in order to demonstrate a clinical impact.
KeywordsInfectious diseases consultation IDC Adherence to recommendations Clinical outcomes
- Clinical benefit of infectious diseases consultation: a monocentric prospective cohort study
Volume 40, Issue 5 , pp 501-507
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- Infectious diseases consultation
- Adherence to recommendations
- Clinical outcomes
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- Author Affiliations
- 1. Infectious Diseases Unit, University Hospital of Caen, 14000, Caen, France
- 2. Department of Hygiene and Public Health, University Hospital of Caen, 14000, Caen, France
- 3. Department of Microbiology, University Hospital of Caen, 14000, Caen, France