1079. Impact of Antimicrobial Stewardship Program (ASP) on Patients with Neurological Conditions

Abstract

BackgroundRising rates of antimicrobial resistance worldwide has dire consequences on patient care, as infections with resistant organisms impair patients’ recovery, resulting in protracted illness and hence prolonged hospital stay. Antimicrobial Stewardship Programs (ASPs) have shown to effectively reduce antibiotic resistance. Locally, we observed that patients with neurological conditions were often initiated on antibiotics for change in mental state or isolated fevers. Little is known whether these patients truly require antibiotics and hence, we aim to study the impact of ASP in these patients.MethodsRetrospective review of ASP database between January 2014 and December 2017 was conducted, among all patients admitted to the neurology department in SGH and in whom the ASP team recommended discontinuation of empiric use of antibiotics. Demographics were collected. Clinical outcomes, duration of antibiotics therapy, length of hospital stay (LOS), infection-related readmissions and mortality, were compared between interventions accepted and rejected groups.ResultsThe ASP team recommended 184 interventions [overall acceptance rate of 82.6% (152/184)]. There was no significant difference in underlying demographics, and Charlson Co-morbidity score between the 2 groups. However, the interventions-acceptance group had shorter duration of therapy by 1.67 days (4.99 ± 2.50 days vs. 6.66 ± 2.34 days; P < 0.01) and LOS by 2 days (22.5 ± 51.4 days vs. 24.5 ± 3.04 days; P = 0.83). There were no significant differences in 14-day mortality and readmission rates between the 2 groups.ConclusionIn patients with neurological conditions, ASP interventions were safe, and associated with a significant reduction in the duration of therapy and LOS.Disclosures All authors: No reported disclosures.