Antibiotic misuse: a prospective clinical audit in a French university hospital

  • C. Pulcini
  • E. Cua
  • F. Lieutier
  • L. Landraud
  • P. Dellamonica
  • P. M. Roger
Concise Article


The aim of the study presented here was to prospectively audit antibiotic prescriptions given to patients attending L’Archet Hospital in Nice, France, with details of the initial medical examination included in the audit procedure. A total of 122 antibiotic treatments were evaluated, i.e. 31% of all antibiotic therapies initiated in the eight participating departments over the 9-week study period. Forty-two (34%) treatments were found to be unnecessary due to misdiagnosis, and 36 (30%) other treatments were inappropriate. Misdiagnosis, due to the misinterpretation or lack of clinical, microbiological and/or imaging data is thus a major cause of antibiotic misuse. Improvement in the diagnostic process should become part of antibiotic policy.


  1. 1.
    Maki DG, Schuna AA (1978) A study of antimicrobial misuse in a university hospital. Am J Med Sci 275:271–282PubMedCrossRefGoogle Scholar
  2. 2.
    Tünger Ö, Dinç G, Özbakkaloglu B, Atman UC, Algun U (2000) Evaluation of rational antibiotic use. Int J Antimicrob Agents 15:131–135PubMedCrossRefGoogle Scholar
  3. 3.
    Ochoa C, Eiros JM, Inglada L, Vallano A, Guerra L (2000) Assessment of antibiotic prescription in acute respiratory infections in adults. J Infect 41:73–83PubMedCrossRefGoogle Scholar
  4. 4.
    Thuong M, Shortgen F, Zazempa V, Girou E, Soussy CJ, Brun-Buisson C (2000) Appropriate use of restricted antimicrobial agents in hospitals: the importance of empirical therapy and assisted re-evaluation. J Antimicrob Chemother 46:501–508PubMedCrossRefGoogle Scholar
  5. 5.
    Kumarasamy Y, Cadwagan T, Gillanders IA, Jappy B, Laing R, Gould IM (2003) Optimizing antibiotic therapy—the Aberdeen experience. Clin Microbiol Infect 9:406–411PubMedCrossRefGoogle Scholar
  6. 6.
    Bugnon-Reber AV, de Torrenté A, Troillet N, Genne D, ETUDAS group (2004) Antibiotic misuse in medium-sized Swiss hospitals. Swiss Med Wkly 134:481–485PubMedGoogle Scholar
  7. 7.
    Potocki M, Goette J, Szucs TD, Nadal D (2003) Prospective survey of antibiotic utilization in pediatric hospitalized patients to identify targets for improvement of prescription. Infection 31:398–403PubMedGoogle Scholar
  8. 8.
    Erbay A, Colpan A, Bodur H, Cevik MA, Samore MH, Ergonul O (2003) Evaluation of antibiotic use in a hospital with an antibiotic restriction policy. Int J Antimicrob Agents 21:308–312PubMedCrossRefGoogle Scholar
  9. 9.
    Erbay A, Bodur H, Akinci E, Colpan A (2005) Evaluation of antibiotic use in intensive care units of a tertiary care hospital in Turkey. J Hosp Infect 59:53–61PubMedCrossRefGoogle Scholar
  10. 10.
    Zahar JR, Ghaffari P, Kamga I, Perronne V (2003) Audit des prescriptions antibiotiques dans un service de maladies infectieuses: enquête prospective observationnelle. Presse Med 32:1208–1212PubMedGoogle Scholar
  11. 11.
    Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM (1988) CDC definitions for nosocomial infections, 1988. Am J Infect Control 16:128–140PubMedCrossRefGoogle Scholar
  12. 12.
    Van der Meer JWM, Gyssens IC (2001) Quality of antimicrobial drug prescription in hospital. Clin Microbiol Infect 7(Suppl 6):12–15PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • C. Pulcini
    • 1
  • E. Cua
    • 1
  • F. Lieutier
    • 2
  • L. Landraud
    • 3
  • P. Dellamonica
    • 1
  • P. M. Roger
    • 1
  1. 1.Service d’Infectiologie, Hôpital L’Archet 1Centre Hospitalier Universitaire de NiceNice Cedex 3France
  2. 2.Pharmacie, Hôpital L’Archet 2Centre Hospitalier Universitaire de NiceNice Cedex 3France
  3. 3.Service de Bactériologie, Hôpital L’Archet 2Centre Hospitalier Universitaire de NiceNice Cedex 3France

Personalised recommendations