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CP-135 Monitoring and rationalisation of antibiotics prescribed in hospitals
  1. J Calisto1,
  2. F Tátá1,
  3. C Azevedo2,
  4. ML Pereira1
  1. 1Hospital Espírito Santo Évora- EPE, Serviço Farmacêutico, Évora, Portugal
  2. 2Hospital Espírito Santo Évora- EPE, Unidade de Infeciologia, Évora, Portugal

Abstract

Background In recent years, resistance of K pneumoniae E coli, and strains of methicillin resistant Staphylococcus aureus (MRSA) to carbapenems and fluoroquinolones has been increasing. To avoid antibiotic resistance, it is necessary to reserve carbapenems and fluoroquinolones for those situations where there is no therapeutic alternative, as they are a weapon that can play a decisive role in the fight against healthcare associated infections.

Purpose

  • To analyse antibiotic prescriptions in hospital wards

  • to reduce consumption and duration of antibiotic therapy in hospitals; and

  • to develop strategies to minimise errors found in the prescription of antibiotics

Material and methods Selection of cases through prescription analysis:

– all antibiotic prescriptions.

Data collection and recording in the database:

– antibiotic prescriptions;

– clinical Information;

– laboratory analyses (C reactive protein, procalcitonin, antimicrobial susceptibility test);

– pharmaceutical report;

– if the pharmaceutical report is unfavourable, the prescribing physician will be contacted;

– infectious disease specialist report.

Data analysis to develop strategies that promote the rational use of antibiotics.

Results 331 antibiotic prescriptions were analysed: 48% were accepted, 28% were accepted when the laboratory results were available, 14% were suspended and 10% had to be changed to another antibiotic.

Of the total antibiotic prescriptions, 11% were quinolones and 6% were carbapenems. About 18% of antibiotic prescriptions had a longer duration than the therapeutic indication. Of all antibiotic prescriptions, 59% had negative blood cultures.

Conclusion The role of the hospital pharmacist is essential in the coordination of various players: infectious disease services, pharmaceutical services and pathology laboratory.

The need to implement stop orders as a tool in antibiotic prescriptions was identified, as was the need to monitor prescriptions with negative blood culture results.

More than 50% of all antibiotic prescriptions reviewed were questionable, which reveals the need for monitoring of antibiotic prescriptions by a multidisciplinary team.

References and/or Acknowledgements Antimicrobial resistance: global report on surveillance 2014. Geneva: World Health Organisation; 2014 (http://www.who.int/drugresistance/documents/surveillancereport/en/) or monitoring of antibiotic prescriptions by a multidisciplinary team.

No conflict of interest.

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