EP.FRI.508 Improving Antibiotic Stewardship on General Surgical Wards

Abstract

Abstract Aims Good antibiotic stewardship is a core part of patient care. It has been shown to reduce antibiotic resistance and improve overall patient outcomes. The primary aim was to improve compliance with national antibiotic prescribing guidance. In doing so, we sought to improve documentation of antibiotic duration; reduce the duration of intravenous antibiotics and gentamicin courses; and length of stay in hospital. Methods 50 general surgery inpatients at a district general hospital over a 2-week period were included in cycle 1. All eligible patients on antibiotics were included. Patients were excluded if under 18 years; discharged within 24 hours; or on antibiotics for prophylaxis. Intervention was a poster and education sessions with prescribers. Cycle 2 gathered data from a further 50 patients from the same wards over 10 days. Results There were improvements in documentation of antibiotic duration (from 1% to 52%, p = 0.001); prescription of antibiotics in line with guidance (from 74% to 90%, p = 0.0376) and number of patients on intravenous antibiotics (reduced from 89% to 72%, p = 0.0307). Duration of gentamicin courses also improved: from 23% patients getting more than 72 hours of gentamicin, to 0% post intervention. Length of stay was also reduced, however was not statistically significant (4.98 days to 4.10 days, p = 0.259). Conclusions This simple audit intervention improved antibiotic stewardship on surgical wards, which is an essential part of overall care for patients. Future work could be done to further improve on this, including a prompt via electronic prescribing and targeted interventions in other clinical areas, e.g. ICU.