Background The implementation of an Antimicrobial Stewardship Program (ASP) in our hospital has attempted to streamline the use of antibiotics. Within this program, pharmacist interventions have been introduced on the de-escalation of antimicrobial treatment and on the adjustment of duration of treatment.
Purpose To analyse ertapenem prescriptions since establishing pharmacist interventions in a tertiary university hospital.
Material and methods This was a retrospective study where we compared ertapenem prescriptions dispensed between March and May 2012 with the prescriptions dispensed in the same period in 2014. We analysed the following variables: number of prescriptions, request for microbiological cultures, duration of treatment, indication and de-escalation performed. The Oncology-Haematology, Orthopaedics and Trauma, Neurosurgery and Neurology, Paediatrics and Gynaecology departments were excluded. To measure and compare the drug consumption, we used the Daily Defined Doses (DDD) per 100 stays.
Results In 2012, there were 167 prescriptions for ertapenem, while in 2014, this figure was110. Microbiological cultures were requested in 64% of cases in 2012 and in 68% in 2014. The mean duration of treatment was 5 days in 2012 and 4 days in 2014. In 2012, ertapenem treatment was interrupted because of discharge from hospital (39.5%), escalation or replacement with other antibiotic with similar spectrum of coverage 37.1% and de-escalation (18.6%); in 2014, these percentages were 37.5%, 27.9% and 29.1% respectively. In 2012, ertapenem was most commonly prescribed for intra-abdominal infections (45.0%), skin and soft tissues infections (21.6%) and respiratory infections (19.0%); whereas in 2014, it was prescribed for intra-abdominal (46%), urinary (20%) and respiratory (18.5%) infections. The DDD per 100 stays in 2012 was 2.9 and in 2014 was 1.5
Conclusion Since the launch of ASP, we have observed that the consumption of ertapenem has decreased significantly. The duration of treatment is also shorter thanks to the system for de-escalation. Still, more microbiological tests need to be requested
References and/or acknowledgements No conflict of interest.
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