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PS-003 Safety and economic outcome after implementation of a restricted use antibiotic protocol
  1. E Tevar1,
  2. A De León-Gil1,
  3. JC Febles2,
  4. T Betancor-Garcia1,
  5. I Plasencia-Garcia1,
  6. MA Ocaña-Gomez1,
  7. S Ramos-Linares1,
  8. P Díaz1,
  9. E Marqués1,
  10. J Merino1
  1. 1Hospital Nuestra Señora de Candelaria, Farmacia, Santa Cruz de Tenerife, Spain
  2. 2Hospital Nuestra Señora de Candelaria, Computing Service, Santa Cruz de Tenerife, Spain

Abstract

Background In 2013, our protocol of restricted use antibiotics (RUA) was updated and computerised.

The following drugs were subject to their respective indications. Ertapenem: community intra-abdominal infection with risk factors, moderate or severe diabetic foot infections and outpatient management. Linezolid: pneumonia, diabetic foot infections, osteomyelitis and prosthetic infections, and serious bile duct infections. Daptomycin: endocarditis, diabetic foot infections, osteomyelitis and prosthetic infections, and right sided endocarditis. Tigecycline: complicated intra-abdominal infections or soft tissue infections, except diabetic foot infections, if there is no alternative.

Purpose To evaluate RUA outcomes 1 year after implementation.

Material and methods Computerised orders received in 2013; retrospective analysis.

Results 500 requests for RUA were conducted: 22% ertapenem, 37.2% linezolid, 35.2% daptomycin and 5.6% tigecycline. The antibiotics were used as follow: ertapenem: intra-abdominal infections in 50.91%, diabetic foot infections 15.45%, peritonitis 9.1% and 27 patients (24.54%) to promote outpatient management.

Linezolid: 32.26% skin and soft tissue infections, 30.12% pneumonia, 13.5% biliary tract infections, 9.6% osteomyelitis and prosthesis infections and 6.99% in diabetic foot infections.

Daptomycin: 42.61% in infections of skin and soft tissues, 18.79% in bacteraemia, 13.07% in endocarditis, 10.8% in biliary tract infections; for hospital management, osteomyelitis and prosthetic infections, and diabetic foot infections were requested in 13.7% and 6%, respectively. Tigecycline: 11 cases of intra-abdominal infection and 17 skin and soft tissue infections.

The RUA spending in 2013 compared with the previous year decreased by €31 843. Daptomycin increased slightly (€1461) while consumption of tigecycline and ertapenem was reduced by €14 254 and €13 131, respectively. This was a 45.7% and 31.5% reduction in costs over the previous year. Linezolid spending was also reduced €5920, slightly over (2%) the previous year.

Conclusion The update and computerisation of the RUA protocol has achieved a reduction in spending on these antibiotics and improved adjustment of the prescriptions to the current indications for these drugs.

References and/or Acknowledgements Hospital Computing Service.

No conflict of interest.

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