[Prognostic factors of pneumococcal meningitis. Retrospective study of 31 cases]

Our aim was to study the susceptibility of Streptococcus pneumoniae to antibiotics in patients with pneumococcal meningitis and to search for the prognosis factors in those patients. We have studied retrospectively 31 cases of pneumococcal meningitis. Comparisons were performed with univariate analysis. The mean age was 36,7 +/- 20,5 years [ranged: 9 and 78 years]. The sex ratio was 3,4. The susceptibility of Streptococcus pneumoniae to penicillin G was affected in 10 cases [33% of isolated pneumococcus. The MIC to penicillin G was >/= 2 in only one case. The hospital mortality was 26% [8/31]. With univariate analysis, factors associated with death were: age >/= 55 years [Ss p= 0,006, OR: 17.2; IC[95%]: 2.3-134], albuminorachie >/= 7g/l [p= 0,002, OR: 22; IC[95%]: 1,9-251], shock [p= 0,031, OR: 6.7; IC[95%],: 1.05-42] and Glasgow Coma Score [GCS] /= 7g/l shock and Glasgow Coma Score

Evaluation de la consommation des antibiotiques dans un h“pital universitaire Tunisien

Purpose: To estimate the consumption of antibiotics in our hospital and to determine the points at which the recommendations of good practice of antibiotherapy will be targeted. Patients and methods: Our study is a one day prevalence study where antibiotic prescriptions are analyzed by a group of 6 doctors referents in antibiotherapy. During the study day, 443 patients were studied. Means age was 44.2 +/- 23.3 years [range: 1 and 102 years]. 101 infections were diagnosed in 48 patients [10.8%]. 192 patients [43.3%] received antibiotics. Antibiotherapy was curative in 44% of cases. The most prescribed antibiotics were gentamicin [85.2 DDD/1000 patients], metronidazole [79 DDD/1000 patients], and cefotaxime [73.9 DDD/1000 patients]. According to the evaluation group, 30.7% of the antibiotic prescription was considered unjustified. The antibioprophylaxis represents the category most often unjustified [49%]. The molecules in which prescription was frequently considered unjustified are the ciprofloxacin [67%], the amoxicillin-clavulonate [40%] and the cefotaxime [40%]. Our results suggest that an action of good practice should be targeted at the antibioprophylaxis and should concern especially molecules in which prescription was frequently unjustified