Résumé
Objective: this thesis aims to evaluate antibiotic prescribing practices in geriatrics at the Montpellier University Hospital (CHU) with the goal of improving practices and shortening treatment duration when recommended. Method: we conducted a retrospective observational study in geriatric departments, including a three-phase clinical audit. Antibiotic prescriptions were analyzed over two two-month periods (March/April 2023 and April/May 2024), with an informative intervention between the two to raise prescriber awareness and remind them of recent guidelines. Results: a total of 213 patients were included. The results show a median prescribed antibiotic duration of 8 days, which is one day longer than recommended (p=0.002), mainly for pneumonia and pyelonephritis. After the intervention, adherence to guidelines for pyelonephritis significantly increased from 26.67% to 78.95% (p=0.005). CRP levels on the third day were a negative predictive factor for adherence to guidelines (p=0.0127). Non-compliance with guidelines was significantly associated with the occurrence of side effects (p=0.0127). Conclusion: the study highlights the usefulness of clinical audits in improving antibiotic prescribing practices in geriatrics. It also emphasizes the importance of raising physician awareness of the latest guidelines, which are regularly updated. However, there remains a reluctance among prescribers to apply "standard" adult guidelines to the geriatric population with multiple comorbidities, particularly due to the misinterpretation of CRP levels on the third day, which prolongs antibiotic treatment. Finally, there was an observed increase in complications in the "non-compliant" group, which requires further confirmation through additional studies.