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Raveloson H, Ben Hassen J, Koraib R, Jhouri A, Schlatter J. Appropriate prescription of cytobacteriological urine examinations in older adults. Urologia 2024:3915603241244936. [PMID: 38557329 DOI: 10.1177/03915603241244936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Cytobacteriological urine examinations (CBEU) are frequently ordered for the older adults, sometimes without straightforward indication and with the risk of prescribing empirical antibiotics. The aim of this study was to evaluate the relevance of the CBEU prescription and empiric antibiotic therapy in our geriatric hospital. Among 129 patients (mean age 84 years, sex ratio 0.69), 229 CBEU were collected with 20.9% of inappropriate indication. Cultures were sterile in 43% (n = 99) of cases and positive in 57% (n = 130) cases. Gram-negative bacilli dominated the isolated bacteria (76.9%) followed by gram-positive cocci (17.6%). In 113 patients, probabilistic antibiotic therapy was prescribed of which 68 treatments were initiated before the CBEU. Ceftriaxone and amoxicillin plus clavulanic acid were the main therapeutic option used representing 70.8% of cases. Antibiotic therapy was re-evaluated after 3 days in 74.3% of patients. Efforts to reduce the number of useless ECBUs by training doctors to follow official guidelines are a priority.
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Affiliation(s)
| | - Jihène Ben Hassen
- Assistance Publique des Hôpitaux de Paris, Hôpital Paul Doumer, Labruyère, France
| | - Rihab Koraib
- Assistance Publique des Hôpitaux de Paris, Hôpital Paul Doumer, Labruyère, France
| | - Aziza Jhouri
- Assistance Publique des Hôpitaux de Paris, Hôpital Paul Doumer, Labruyère, France
| | - Joël Schlatter
- Assistance Publique des Hôpitaux de Paris, Hôpital Paul Doumer, Labruyère, France
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Ladjouzi N, Romdhani A, Zouloumis G, Ould Ouali C, Jhouri A, Schlatter J. Reassessment of Treatments in a Long-Term Care Unit. Gerontol Geriatr Med 2023; 9:23337214231156030. [PMID: 36819230 PMCID: PMC9932759 DOI: 10.1177/23337214231156030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/11/2023] [Accepted: 01/21/2023] [Indexed: 02/16/2023] Open
Abstract
The risks of iatrogenic medication related adverse events are high among older patients. Assessing prescriptions is critical to prevent overusing, underusing, or misusing medications. The aim of this study is to evaluate the prescription reassessment in older patients hospitalized in long-term care unit. Among the 30 patients (M age = 83 years, woman 66%), polymedication was present, patients taking 5 to 18 drugs (mean 11 drugs). The length of stay varied from 92 days to 4.5 years (mean 564 ± 430 days). The prescription reassessment of the patients hospitalized in our long-term care unit varied from 1 to 125 days with a mean of 16 days. Plan the prescription reassessment could reduce the iatrogenic medication in weakened patients.
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Affiliation(s)
- Nadia Ladjouzi
- Hôpital Paul Doumer, Assistance
Publique des Hôpitaux de Paris, Labruyère, France
| | - Ahmed Romdhani
- Hôpital Paul Doumer, Assistance
Publique des Hôpitaux de Paris, Labruyère, France
| | - Georges Zouloumis
- Hôpital Paul Doumer, Assistance
Publique des Hôpitaux de Paris, Labruyère, France
| | - Cid Ould Ouali
- Hôpital Paul Doumer, Assistance
Publique des Hôpitaux de Paris, Labruyère, France
| | - Aziza Jhouri
- Hôpital Paul Doumer, Assistance
Publique des Hôpitaux de Paris, Labruyère, France
| | - Joël Schlatter
- Hôpital Paul Doumer, Assistance
Publique des Hôpitaux de Paris, Labruyère, France,Joël Schlatter, Hôpital Paul Doumer,
Assistance Publique des Hôpitaux de Paris, 1 route de l’hôpital, Labruyère
60140, France.
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Ould Ouali C, Ladjouzi N, Tamas K, Raveloson H, Ben Hassen J, El Omeiri N, Zouloumis G, Al Zoabi MM, Asadi M, Jhouri A, Schlatter J. Efficacy of Single Tocilizumab Administration in an 88-Year-Old Patient with Severe COVID-19 and a Mini Literature Review. Geriatrics (Basel) 2022; 7:geriatrics7010022. [PMID: 35200527 PMCID: PMC8872498 DOI: 10.3390/geriatrics7010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/14/2022] [Accepted: 02/18/2022] [Indexed: 12/15/2022] Open
Abstract
The new coronavirus disease 2019 (COVID-19) could be associated with elevated inflammatory cytokine levels, suggesting the involvement of cytokine release syndrome. This syndrome is characterized by release of interleukin 6 correlated with COVID-19 severity and mortality. Targeting IL-6 with Tocilizumab treatment could be a potential therapeutic option for old patients. We report the case of an 88-year-old man with COVID-19 disease who presented at the admission with anemia, fever, oxygen desaturation (92%), and inflammatory syndrome (C-reactive protein (CRP) at 182.5 mg/L; reference range <5.0 mg/L). After remaining CRP level increase (206.6 mg/L), Tocilizumab administration led to rapid clinical outcome and resolution of his inflammatory syndrome. This case report represents a supplementary data confirming the efficacy and safety of Tocilizumab for COVID-19 in elderly patients.
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Affiliation(s)
- Cid Ould Ouali
- Department of Post-Acute and Rehabilitation Care, Department of Critical Geriatric Medicine, Hospital of Paul Doumer, Assistance Publique des Hôpitaux de Paris (AP-HP), 60140 Labruyère, France; (C.O.O.); (N.L.); (K.T.); (H.R.); (J.B.H.); (N.E.O.); (G.Z.); (M.M.A.Z.); (M.A.)
| | - Nadia Ladjouzi
- Department of Post-Acute and Rehabilitation Care, Department of Critical Geriatric Medicine, Hospital of Paul Doumer, Assistance Publique des Hôpitaux de Paris (AP-HP), 60140 Labruyère, France; (C.O.O.); (N.L.); (K.T.); (H.R.); (J.B.H.); (N.E.O.); (G.Z.); (M.M.A.Z.); (M.A.)
| | - Khidher Tamas
- Department of Post-Acute and Rehabilitation Care, Department of Critical Geriatric Medicine, Hospital of Paul Doumer, Assistance Publique des Hôpitaux de Paris (AP-HP), 60140 Labruyère, France; (C.O.O.); (N.L.); (K.T.); (H.R.); (J.B.H.); (N.E.O.); (G.Z.); (M.M.A.Z.); (M.A.)
| | - Hendriniaina Raveloson
- Department of Post-Acute and Rehabilitation Care, Department of Critical Geriatric Medicine, Hospital of Paul Doumer, Assistance Publique des Hôpitaux de Paris (AP-HP), 60140 Labruyère, France; (C.O.O.); (N.L.); (K.T.); (H.R.); (J.B.H.); (N.E.O.); (G.Z.); (M.M.A.Z.); (M.A.)
| | - Jihene Ben Hassen
- Department of Post-Acute and Rehabilitation Care, Department of Critical Geriatric Medicine, Hospital of Paul Doumer, Assistance Publique des Hôpitaux de Paris (AP-HP), 60140 Labruyère, France; (C.O.O.); (N.L.); (K.T.); (H.R.); (J.B.H.); (N.E.O.); (G.Z.); (M.M.A.Z.); (M.A.)
| | - Nesrine El Omeiri
- Department of Post-Acute and Rehabilitation Care, Department of Critical Geriatric Medicine, Hospital of Paul Doumer, Assistance Publique des Hôpitaux de Paris (AP-HP), 60140 Labruyère, France; (C.O.O.); (N.L.); (K.T.); (H.R.); (J.B.H.); (N.E.O.); (G.Z.); (M.M.A.Z.); (M.A.)
| | - Georges Zouloumis
- Department of Post-Acute and Rehabilitation Care, Department of Critical Geriatric Medicine, Hospital of Paul Doumer, Assistance Publique des Hôpitaux de Paris (AP-HP), 60140 Labruyère, France; (C.O.O.); (N.L.); (K.T.); (H.R.); (J.B.H.); (N.E.O.); (G.Z.); (M.M.A.Z.); (M.A.)
| | - Mohamed Moataz Al Zoabi
- Department of Post-Acute and Rehabilitation Care, Department of Critical Geriatric Medicine, Hospital of Paul Doumer, Assistance Publique des Hôpitaux de Paris (AP-HP), 60140 Labruyère, France; (C.O.O.); (N.L.); (K.T.); (H.R.); (J.B.H.); (N.E.O.); (G.Z.); (M.M.A.Z.); (M.A.)
| | - Muneer Asadi
- Department of Post-Acute and Rehabilitation Care, Department of Critical Geriatric Medicine, Hospital of Paul Doumer, Assistance Publique des Hôpitaux de Paris (AP-HP), 60140 Labruyère, France; (C.O.O.); (N.L.); (K.T.); (H.R.); (J.B.H.); (N.E.O.); (G.Z.); (M.M.A.Z.); (M.A.)
| | - Aziza Jhouri
- Pharmacy, Hospital of Paul Doumer, Assistance Publique des Hôpitaux de Paris (AP-HP), 60140 Labruyère, France;
| | - Joël Schlatter
- Pharmacy, Hospital of Paul Doumer, Assistance Publique des Hôpitaux de Paris (AP-HP), 60140 Labruyère, France;
- Correspondence:
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