CP-011 Length of antimicrobial use and the role of the pharmacist in an acute hospital setting

Abstract

Background Spain accounts for the highest antibiotic use in Europe. Different studies have reported between 30 and 50% of antibiotic treatments are inappropriate in hospital. Purpose To assess the impact of pharmaceutical interventions in controlling the duration of antimicrobial treatment and to evaluate their impact on optimising the treatment. Material and methods Prospective observational study conducted over 6 months in a tertiary level hospital. Patients with 10 days or longer, ongoing antibiotics courses were reviewed, followed by a recommendation to the physician to review the need for continued treatment. Pharmacy interventions were classified: 1. Duration of treatment compliant with the patient’s clinical condition and trust guidelines; 2. Duration of treatment not supported by the antibiotic policy, but maintained due to the patient’s clinical condition; and 3. Duration not appropriate, hence discontinuation of antibiotic therapy as a result of pharmacy intervention. Results 132 patients on ongoing antibiotic treatment ≥10 days were identified, 35.7% of whom were female, mean age 63 ± 16.3. In 76 cases (57%), the total duration fell into the first category, whereas in 36 and 20 cases, the duration fell into categories 2 and 3, respectively. A reduction in the number of patients on long-term antibiotics was observed since the commencement of the study: 30 patients in March 2014, 21 (April), 20 (May), 21 (June), 19 (August), and 21 (September). According to their pharmacological class, β-lactams, particularly imipenem (11%) and ceftriaxone (11%) were the group of antibiotics with the highest number of interventions, followed by quinolones, mainly levofloxacin. The most involved prescriber specialty was internal medicine (22%). Conclusion Only 15% of pharmacist interventions on antibiotic duration resulted in discontinuation of the ongoing regimen. Nevertheless, there was a positive trend towards a reduction in the overall length of antimicrobial treatment over the study period. References and/or acknowledgements No conflict of interest.