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4CPS-041 Implementation of an empirical antibiotic treatment guide: impact on antiobitic prescription in an emergency department
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  1. L Otero millan1,
  2. A Perez-Landeiro1,
  3. C Casanova martinez1,
  4. MT Perez-Rodriguez2,
  5. L Martinez Lamas3,
  6. A Blanco Rodicio4,
  7. K Lorenzo Lorenzo1,
  8. L Perez Rodriguez1,
  9. G Piñeiro Corrales1
  1. 1Hospital Álvaro Cunqueiro, Pharmacy, Vigo, Spain
  2. 2Hospital Álvaro Cunqueiro, Internal Medicine, Vigo, Spain
  3. 3Hospital Álvaro Cunqueiro, Microbiology, Vigo, Spain
  4. 4Hospital Álvaro Cunqueiro, Emergency, Vigo, Spain

Abstract

Background An empirical antibiotic treatment guide (EATG) was implemented in our hospital in January 2017. This guide was developed by the antimicrobial stewardship team, composed of infectious disease specialists, microbiologists and pharmacists. The aim was to optimize the antibiotic prescription, avoiding the use of antibiotics associated with resistance development, such as quinolones, third-generation cephalosporins and carbapenems.1,2

Purpose To evaluate changes in the antibiotic consumption and their costs, after the EATG implementation in the Emergency Department of our hospital.

To analyse changes in the antibiotic prescription profile after this implementation.

Material and methods Retrospective study from 2016 to 2017 in a third-level hospital. The antibiotic consumption data and its costs in 2016 (pre-intervention) and 2017 (post-intervention) were compared. The data were obtained from the hospital pharmacy management programme (antibiotic treatment during the stay in the emergency room) and the primary care management programme (prescription at discharge). Antibiotic consumption is transformed into defined daily doses and adjusted to emergencies attended (EMERG) (data provided by the Admission Service).

The analysis was done in an Excel table 1 and statistical comparisons were performed with Fisher’s exact test provided by Epi Info 7,3 a P-value of less than 0.05 being considered as proof of significance.

Results Antibiotic consumption:

Antibiotic costs:

Abstract 4CPS-041 Table 1

Conclusion We found a significant antibiotic consumption decrease after the implementation of the EATG. This reduction is associated with cost savings.

We noticed important changes in the antibiotic prescription profile: quinolones, third-generation cephalosporins and carbapenems prescriptions decreased (by about 30%–40%) and, simultaneously, amoxicillin clavulanic acid prescriptions increased (by less than 10%).

Levofloxacin is the main factor related to quinolones reduction. This could indicate a proper use of antibiotics in respiratory pathology.

These changes suggest an optimisation of antibiotic prescription in the Emergency Department because we observed a reduction in the use of antibiotics associated with resistance development.

References and/or acknowledgements 1. https://www.ncbi.nlm.nih.gov/pubmed/23836188

2. https://www.ncbi.nlm.nih.gov/pubmed/15127367

3. https://www.cdc.gov/epiinfo/user-guide/statcalc/statcalcintro.html

No conflict of interest.

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