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4CPS-112 Antimicrobial stewardship programme interventions in intensive care unit
  1. R Puértolas1,
  2. S García1,
  3. MD Bellés1,
  4. R Roig2,
  5. I Catalán2,
  6. I Hermosilla2,
  7. B Gomila3,
  8. L Darocas3,
  9. D Marín1,
  10. A Martínez1,
  11. R Ferrando1
  1. 1Hospital General Universitario De Castellón, Hospital Pharmacy, Castellón De La Plana, Spain
  2. 2Hospital General Universitario De Castellón, Intensive Care Unit, Castellón De La Plana, Spain
  3. 3Hospital General Universitario De Castellón, Microbiology, Castellón De La Plana, Spain


Background and Importance The antimicrobial stewardship programmes are essential to achieve appropriate use of antibiotics. The objectives of this multidisciplinary programme (MP) are to optimise the prescription of these drugs to improve patient’s prognosis, to minimise adverse effects, to control the emergence of antimicrobial resistance and to ensure the use of cost-effective treatments. The intensive care units are complex ones with a high percentage of patients with antibiotic treatment.1

Aim and Objectives To describe the interventions carried out by a MP in terms of antimicrobial stewardship and its acceptance in an intensive care unit (ICU).

Material and Methods A retrospective descriptive study was conducted between January 2023 and September 2023 in a tertiary hospital. Intensivists, pharmacists and microbiologists composed the MP.

Variables included were number of ICU admission, number of patients with antibiotic prescription, number of interventions, type of interventions and acceptance rate. This MP met daily to review antibiotics prescriptions in ICU. The interventions were classified into nine groups: therapeutic indication or addition of another antibiotic, discontinuation, therapeutic window, de-escalating, therapeutic drug monitoring (TDM), dosage adjustment, microbiological cultivation and central venous or urinary catheters replacement.

Results A total of 4770 clinical episodes were reviewed of which 47.2% of cases involved at least one antibiotic. The MP performed 947 interventions. The 17,7% was related with therapeutic indication or addition of another antibiotic, the 16,3% to discontinuation the antibiotic, the 3,3% to therapeutic window, the 20,1% to de-escalating, the 12,0% to TDM, the 12,7% to dose adjustment, the 15,2% to microbiological cultivation, the 0,4% to central venous catheter replacement and the 3,4% to urinary catheter replacement. 98,2% of the suggestions were accepted.

Conclusion and Relevance The antimicrobial stewardship programme interventions obtained an acceptance ratio >98% in that period. This programme has been included in the daily clinical practice in ICU being essential to ensure the appropriate use of antimicrobial therapy. The integration of a clinical pharmacist in this MP increases the optimisation of the antimicrobial treatment particularly in terms of efficacy, medication safety through dose adjustment and TDM, and cost effectiveness.

References and/or Acknowledgements 1. Programas de Optimización de Uso de los Antibióticos (PROA) [Internet]. Plan Nacional Resistencia Antibióticos [cited september 2023]. Available in:

Conflict of Interest No conflict of interest.

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