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4CPS-027 Antibiotic therapy reassessment and its documentation: can virtual tools improve practices?
  1. M Bonsergent1,
  2. C Humbert1,
  3. L Escaut2,
  4. D Osman3,
  5. A Barrail-Tran1
  1. 1Chu Bicêtre, Pharmacy, 94270 Kremlin-Bicêtre, France
  2. 2Chu Bicêtre, Infectious Diseases, 94270 Kremlin-Bicêtre, France
  3. 3Chu Bicêtre, Medical Reanimation, 94270 Kremlin-Bicêtre, France


Background and importance Documentation of 48–72 hour antibiotic therapy reassessment is one of the evaluation criteria of good antibiotic use in health facilities. This item is only found in 30–50% of patient medical records in the literature.

Aim and objectives To assess the documentation at 72 hours of reassessment of antibiotic therapy in the medical records and to assess the impact of antibiotic awareness with virtual tools.

Material and methods A first audit of the 48–72 hour antibiotherapy reassessment documentation was carried out. A total of 200 patient records were drawn randomly from 10 units. Following the results, several corrective actions were conducted. Results were presented to units, followed by a free discussion with prescribers. Then, an e-learning module was developed and validated by the local antibiotic commission.

This module contained 3 clinical cases and 13 questions emphasising reassessment and its documentation. A pop-up alert in the prescribing software was created for each antibiotic and a reminder of the 48–72 hour reassessment in the medical record. After corrective actions, a second audit was carried out to assess the effects of these actions.

Results In the first audit, 59% (n=118/200) of antibiotic reassessments were documented in the medical records. After the 5 month intervention, this rate increased to 74% (n=148/200) (p<0.05). Eight of the 10 units got feedback on their results by presenting in their unit. A total of 137 physicians did the e-learning module and global satisfaction was 8/10. Among them, 88% appreciated the online format and would like to receive other similar formats. The antibiotic de-escalated rate did not change significantly between the periods. However, antibiotic therapies without de-escalation at 72 hours were recorded more often (p<0.05). Amoxicillin-ac clavulanic (AMC) was the most prescribed drug, but was also documented the least in the patient medical records (31.3%). After corrective actions, documentation of reassessment of AMC increased to 63%

Conclusion and relevance E-learning and physician awareness allowed a significant increase in documentation of antibiotic reassessment between the two reporting periods. However, improvement in practice must be coupled with long term awareness to obtain a sustained impact on actions.

References and/or acknowledgements No conflict of interest.

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