1268. A retrospective observational study to evaluate the efficacy of antimicrobial time-out for optimizing the duration of antimicrobial administration in emergency abdominal surgery patients

Abstract

Abstract Background Appropriate use of antibiotics is important for the prevention of antimicrobial-resistant organisms. However, prolonged administration of broad-spectrum antimicrobial agents is frequently used in surgery, especially in emergency surgery with infection. The low rate of the appropriate use of antimicrobial agents is regarded as a worldwide problem. In order to promote the proper use of antimicrobials, our department has administered daily antimicrobial time-outs to surgical patients as part of the Antimicrobial Stewardship Program since January 2018. This study investigates whether the Antimicrobial Time-out has led to appropriate use of antibiotics. Methods Patients aged 18 years and older who underwent emergency abdominal surgery in our department from May 2017 to August 2018 were included. Pre- and postoperative clinical information was extracted from the medical records. Results 56 and 66 patients were treated before and after the introduction of antimicrobial time-out, respectively. The mean duration of antimicrobial use was 3.8 and 3.3 days before and after the introduction of antibiotic time-out. No significant difference was observed, but a 13.7% decrease was observed (P=0.51). Limiting the analysis to patients who received a minimum of two days of antimicrobial therapy, treated patients were 23 and 27, and the mean duration of antimicrobial use was 7.8 and 6.6 days(P=0.38) before and after the introduction of antibiotic time-out, respectively. There were also no significant differences in the incidence of complications (Clavien-Dindo classification Grade II or higher) (28.6% vs. 25.8%, P=0.73) or length of hospital stay (17.2 vs. 14.0 days, P=0.38). Conclusion Antibiotic time-out in surgical practice may contribute to a reduction in antimicrobial use without increasing complication rates or length of hospital stay. Disclosures All Authors: No reported disclosures