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Evaluation of the Appropriate Use of Carbapenems Regarding Patients Taken in Hand by Intensive Care Unit in the Marrakech University Hospital Center

Mouayche Ikhlas, Abdesalam Hiddou, Hanaa Hamdani, Youssef Louardi, CharafHarda, Amra Ziadi, Amina Khayari, Abdelhamid Hachimi, Youssef Mouaffak, Said Younous, Nadia El Idrissi Slitine, Mrabih Rabou Maoulainine, Nabila Soraa, Morocco

Carbapenems are antibiotics of last resort used to treat infections with multi-resistant bacteria. The objective of this study is to analyze the prescriptions of carbapenems (CBP) and evaluate the conformity of the probabilistic prescription of these molecules.
Materials and methods:
This is a prospective study over from 1 August 2016 to 31 December 2016.
100 prescriptions of an antibiotic of the carbapenem class were collected. Percentage of prescriptions for CBP was highest in neonatal intensive care (36%) and adult intensive care (34%). The main indication for prescribing CBP to the different intensive care services was sepsis and septic shock (45%). This prescription was probabilistic in 67% of cases. Nosocomial infection motivated the prescription of CBP in 76% of cases. 27 percent of CBP prescriptions were made to treat a documented infection to a C3G-resistant by production of ESBL. Imipenem was predominantly prescribed in neonatal intensive care unit and adult surgical intensive care unit. Erapenem was prescribed in 28% of Cases in medical intensive care unit and 20% in pediatric intensive care unit. Imipenem was prescribed in accordance with the standards in 88% of cases, ertapenem in 10% of prescriptions and meropenem in 2% of prescriptions. Doses were compliant for 87 prescriptions.
The conformity rate has yet to be re-evaluated and improved. The appointment of a referent in antibiotics is essential to supervise the prescription of these broad spectrum antibiotics and limit their use.

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