[Correct and incorrect usage of antibiotics. Prevalence study in Franche-Comté]

To report the results observed regarding the prescription of antibiotics according to various indications in the Franche-Comté area: curative for a community infection, curative for a nosocomial infection and prophylactic.

A total of 6,038 patients hospitalized in 32 hospital centers of the Franche-comté area were surveyed.

Among the 1,016 (16.8% of the total) patients receiving anti-infection products, 47.7% received anti-infection agents for the treatment of a community infection, 25.9% for a nosocomial infection and 26.4% for prophylaxis. Multiple antibiotherapy was more frequent for the treatment of community infections than for nosocomial infections [p = 0.067, Relative Risk = 1.11, (confidence interval: 95%: 1.00-1.24)]. Sixty percent of the prescriptions of 3rd generation cephalosporines were within the community framework. This class of antibiotics was widely prescribed for the treatment of E. coli infections, multi-sensitive to antibiotics, not only before but after bacteriological documentation. Among the 83 patients treated with fluoroquinolone for a nosocomial infection, 47 (56.6%) were treated with monotherapy. Regarding prophylaxis, 3rd generation cephalosporine and fluoroquinolone, which are not indicated for this, were widely used, in contradiction with the recommendations of the Société Française d'Anesthésie et de Réanimation (French Society of Anesthesia and Reanimation).

This survey, despite the limits related to the prevalence method, shows the high frequency of antibiotic prescriptions that do not conform to the recommendations of the ANDEM (French agency for the assessment of medical practice) and the scientific societies.