4CPS-062 Pharmacist intervention for the improvement in the use of antibiotics in surgery service

Background

According to official data in 2016, antibiotics' (AB) comsumption in surgery service in our centre was 970.75DDD/1000patient-days. In detail, piperacillin-tazobactam (P/T) and amoxicillin-clavulanic (A/C) was 259.47DDD/1000patient-days and 340.38DDD/1000patient-days, respectively. It was observed that an improvement in the use of AB in the surgery service was necessary, since the data are beyond the comsumption of AB in the region where our hospital is situated.

Purpose

To analyse the effectiveness of a programme of pharmacist intervention in the reduction of the global use of antibiotics in inpatient care in the surgery service, with special focus on A/C and P/T consumption.

Material and methods

An interdisciplinary meeting between the surgery and pharmacy departments was held. Here, all the protocols of surgery treatment were revised. It was observed that all of them included P/T as an antibiotic prophylaxis. According to the guidelines, the pharmacist proposed to replace P/T by A/C as a treatment of choice, and restrict the post-surgical treatment to three doses by default, setting it out in the electronic prescription program. In addition, the pharmacist revised daily all the antibiotics prescribed with a duration larger or equal to 7 days, and carried out consultations with the surgeons so that they could value several options: antibiotic de-scaling, to finish treatment andto extract cultures. The global consumption of DDD/1000patient-days and the AC and P/T consumption was drawn from the first semester of 2017, and it was compared to the corresponding data in the first semester of 2016.

Results

The global consumption of antibiotics in the surgery service was reduced from 970.75DDD/1000patient-days in 2016 to 847.37DDD/1000patient-days in 2017 (-10.15%). With regards to A/C, the consumption was reduced from 340.48DDD/1000patient-days in 2016 to 247.78DDD/1000patient-days in 2017 (-27.21%) and the consumption of P/T was reduced from 259.47DDD/1000patient-days in 2016 to 210.58DDD/1000patient-days in 2017 (-18.84%).

Conclusion

The incorporation of a programme of interdisciplinary intervention to optimise the adaptation and duration of antibiotic treatment in the general surgery floor has achieved a reduction in the consumption of antibiotics, specially A/C and P/T, with the presence of the pharmacist.

References and/or Acknowledgements

To the surgery service for their collaboration in this project No conflict of interest