4CPS-173 Pharmaceutical intervention in broad-spectrum antibiotic prescription in hospitalised patients

• Published in: European journal of hospital pharmacy. Science and practice Vol. 29; no. Suppl 1; p. A87
• Main Authors: Sacanella Angles, I, Lopez Broseta, PA, Sanjuan Belda, A, Lloret Llorca, A, Garcia Pardo, G, Mendoza Aguilera, M, Roch Ventura, MA, Esteve Pitarch, E, Hernández, JDLMBoada, Canadell Vilarrasa, L
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 23.03.2022; BMJ Publishing Group LTD
• Subjects: Antibiotics; Bacterial infections; Conflicts of interest; Infections; Pharmaceuticals; Section 4: Clinical pharmacy services
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2022-eahp.182

Background and importanceIndiscriminate use of broad-spectrum antibiotics implies a threat to public health and may cause multidrug-resistant pathogen infections. In this sense, data from the Infectious Disease Society of America (IDSA) revealed that >60% physicians have detected at least one case of pan-resistant and intractable bacterial infection during the previous year.Aim and objectivesThe aim of this study was to analyse the quality of antibiotic prescription (indication and duration of treatment) based on the recommendations of our Antibiotic use Optimisation Program (AOP).Material and methodsA retrospective study (January 2020 to April 2021) of hospitalised patients taking carbapenems, ureidopenicillins, quinolones, cephalosporins or glycopeptides was carried out. We collected demographic information, antibiotic regimen, type and site of the infection and microbiological data from the clinical history management program (SAP). Pharmaceutical interventions over antibiotic prescriptions were mainly associated with starting, interrupting, broadening the spectrum or switching to oral therapy.ResultsWe included 75 patients (64% men, mean age 67.7±13.4 years) with an average stay of 10.3±4.1 days. Most common sites of infection were: soft tissue (25%), intra-abdominal (16.3%), urinary (10%), respiratory (10%) and meningeal (5%). Main pathogens isolated were: Gram-positive cocci (49.4%), Gram-negative bacilli (39.3%), anaerobic cocci (5.7%) and fungi (5.6%).We implemented 142 pharmaceutical interventions such as withdrawing (33.1%), changing (26.8%) or starting (20.4%) a new antibiotic. In addition, switching and/or changing to oral therapy (18.3%) and continuing the treatment (1.4%). Almost all pharmaceutical interventions were accepted for other specialists. Conversely, glycopeptides (22.5%), carbapenems (19.8%), ureidopenicillins (18%), cephalosporins (11.7%) and quinolones (4.5%) were the main antibiotics that we had an impact on.Conclusion and relevanceOur study shows that hospital pharmacists and the Infectious Control Group play an important role in optimising antibiotic regimes in a variable clinical context. Pharmaceutical recommendations have good acceptance and should be particularly targeted at specific antibiotic classes. All these measures may contribute to decreasing the incidence of multiresistant bacterial infections in the hospital.References and/or acknowledgementsConflict of interestNo conflict of interest