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4CPS-051 Antibiotics in the emergency department: is it possible to improve prescriptions for infectious respiratory diseases in ambulatory patients?
  1. P Ruiz Briones,
  2. R García Sánchez,
  3. C Ortega Navarro,
  4. MÁ Amor García,
  5. F García Moreno,
  6. A Melgarejo Ortuño,
  7. S García Sánchez,
  8. Á Narrillos Moraza,
  9. A Herranz Alonso,
  10. M Sanjurjo Saez
  1. Hospital General Universitario Gregorio Marañón, Pharmacy Department, Madrid, Spain


Background and importance Due to the rising rate of antibiotic resistance over the past years, healthcare authorities have developed different strategies to solve this problem. In Spain, the Heath Care Service of Madrid (SERMAS) published the ‘Antibiotics use guide for ambulatory treatment in adults’ in 2019, which is used as a reference document for all health professionals, not only for ambulatory but also for hospital assistance.

Aim and objectives The main objective of the project was to evaluate the adequacy of the SERMAS guide for antibiotic prescriptions to ambulatory patients in the emergency department (ED) in one of the largest hospitals in Madrid

Material and methods One hundred patients who went to the ED during a random period in January 2019 were selected. All were diagnosed with a respiratory infection. Only patients who had an antibiotic prescription for the infectious respiratory disease and took the treatment at home were selected.

To evaluate prescription adequacy, the SERMAS guide was used as the reference. The evaluation took place in consecutive steps: (i) indication (necessity for an antibiotic), (ii) election (antibiotic coverage was correct) and (iii) selection (the selected antibiotic was the best option from the available possibilities). Duration and dose adequacy were evaluated.

Results One hundred patients (50 women and 50 men, median age 53 years old) were selected: 53% of patients (53/100) were treated with an antibiotic, and in 73.6% (39/53) the treatment was properly indicated. Antibiotic coverage was adequate in 94.9% (37/39) of cases. In 27.7% (10/37) of patients, the selected antibiotic was the one recommended by the SERMAS guide. Quinolones and high spectrum antibiotics were the more overused groups. In terms of posology, 15.1% (8/53) of patients had a prescription with the proper dose and 7.5% (4/53) received treatment with the proper dose and duration.

Conclusion and relevance The study showed what experts already knew: antibiotic prescriptions in the ED for ambulatory patients are poorly adjusted to the SERMAS guide, mainly due to longer duration and overuse of certain antibiotic groups. Improvement in antibiotic prescriptions should be a main target to reduce increasing antibiotic resistance.

References and/or acknowledgements No conflict of interest.

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