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CP-120 Comparison of antibiotic consumption and bacterial resistance in two teaching hospitals: impact of a multidisciplinary antibiotic management program
  1. S Pfalzgraf1,
  2. P Guyot1,
  3. B Laluque1,
  4. M Jouannet-Romaszko1,
  5. O Baud2,
  6. J Romaszko3,
  7. S Pelegrin1,
  8. V Sautou1
  1. 1CHU de Clermont-Ferrand, Hopital Gabriel Montpied, Pharmacie, Clermont-Ferrand, France
  2. 2CHU de Clermont-Ferrand, Hopital Gabriel Montpied, Antenne Régionale de Lutte Contre Les Infections Nosocomiales, Clermont-Ferrand, France
  3. 3CHU de Clermont-Ferrand, Hopital Gabriel Montpied, Laboratoire de Bactériologie, Clermont-Ferrand, France

Abstract

Background Hospital 1 (H1) implemented an antibiotic management program in 2006: every antibiotic prescription is reviewed by a pharmacist before dispensing to medical units. Complex cases are reviewed with an infectious diseases specialist. In hospital 2 (H2), only carbapenems are prescribed in this way.

Purpose To identify the program’s possible impact on H1’s antibiotic consumption and bacterial ecology by comparing them to H2’s.

Material and methods Both hospitals’ consumption and resistance data from 2011 to 2013 were extracted from pharmacy management and bacteriology laboratory software, then uploaded on the ConsoRes tool to shape them. Resistance rates were compared using a Fisher’s exact test, mean antibiotic consumptions were compared using Student’s t test.

Results H1’s mean antibiotic consumption was lower than H2’s (572.1 Defined Daily Dose [DDD]/1,000 patient-days; standard deviation [SD], ±22.1, vs. 600.1 DDD/1,000 patient-days; SD, ±15.3; p = 0.012). Out of 19 organism/antibiotic couples, none showed an increasing rate of resistance over time in H1. In H2, the rates of E.coli and E. cloacae resistance to cefotaxime increased (12.7% to 18.4%; p = 0.024; 29.9% to 42.2%; p = 0.002, respectively) and H1’s rates decreased or remained constant (E. coli: 10.5% to 5.9%, p = 0.075; E. cloacae: p = 0.455). The rate of methicillin-resistant S. aureus was higher in H2 than H1 (p = 0.004). H2’s ciprofloxacin consumption was lower than H1’s (p < 0.05). The rate of E. coli resistance to ciprofloxacin decreased in H2 (p = 0.004), and remained constant in H1. These results (consumption and resistance) are consistent with current available literature.

Conclusion Bacterial ecology of the two hospitals evolved differently over time; this might be a consequence of H1’s antibiotic management program. The program might also have had an impact on antibiotic consumption.

References and/or Acknowledgements

  1. Bevilacqua S, Demoré B, Erpelding ML, et al. Effects of an operational multidisciplinary team on hospital antibiotic use and cost in France: a cluster controlled trial. Int J Clin Pharm 2011;33:521–8

  2. Davey P, Brown E, Fenelon L, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev 2005;(4):CD003543

References and/or AcknowledgementsNo conflict of interest.

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