Application of guidelines for aminoglycosides use in French hospitals in 2013–2014

on behalf of the Société de Pathologie Infectieuse de Langue Française (SPILF), the Observatoire National de l’Epidémiologie de la Résistance Bactérienne aux Antibiotiques (ONERBA) and the Surveillance de la Prescription des Antibiotiques (SPA) groupInternational audienceIn 2011, the French Agency for Safety of Health Products issued guidelines underlining the principles of proper aminoglycosides’ use. The aim of the survey was to evaluate adherence to these guidelines two years after their issue. Characteristics of patients receiving aminoglycosides were recorded by voluntary facilities during a 3-month survey in 2013–2014. The modalities of aminoglycosides treatment were analysed by comparison with the French guidelines. A total of 3,323 patients were included by 176 facilities. Patients were mainly hospitalized in medical wards (33.0%), and treated for urinary-tract infections (24.7%). Compliance regarding the clinical indication and the daily aminoglycosides dose was observed in 65.2% and 62.9% of the cases, respectively. A 30-min once-daily IV administration was recorded in 62.5% of the cases. Aminoglycosides treatment duration was appropriate (≤5 days) for 93.6% of the patients. When considering the four criteria together, 23.2% of the patients had a treatment regimen aligned with the guidelines. Requests for measurements of peak and trough AG serum concentrations matched the guidelines in 24.9% and 67.4% of the cases, respectively. Two years after guidelines issue, aminoglycosides use remains unsatisfactory in French health-care facilities. Efforts should be made for guidelines promotion, especially regarding the issue of underdosing