5PSQ-036 Analysis of pharmaceutical interventions on antimicrobial prescriptions in the post-operative resuscitation unit

Background and Importance Multidrug-resistant microorganisms represent one of the greatest challenges in medicine today. The Antibiotic Stewardship Programme (ASP) reviews antimicrobial prescribing and makes recommendations to prescribers to achieve rational use of antibiotics and reduce the risk of resistance development. Aim and Objectives To analyse the interventions carried out on antimicrobial treatment by the ASP in patients admitted to a postoperative resuscitation unit (PRU) and to evaluate the degree of acceptance of them. Material and Methods Retrospective and observational study of the interventions performed by the ASP through daily multidisciplinary meetings from January 2022 to July 2023 in a third-level hospital. Antifungals and broad-spectrum antibiotics considered as 'restricted' in our hospital were reviewed. These included carbapenems, linezolid, daptomycin, caspofungin, voriconazole, etc. Data collected patient demographics, diagnosis (type of infection), treatment (empirical, prophylactic or targeted), restricted antibiotics prescribed and their appropriateness, recommendations made and rate of acceptance. Results 62 patients (53.2% men) were included. 130 restricted antibiotics were reviewed. The most reviewed antimicrobials were, in first place, meropenem (46.9%), followed by caspofungin (24.6%) and linezolid (15.4%). 75.6% of the antibiotic prescriptions were empirical, 22.1% targeted and 2.3% prophylactic. The most common types of infections were intra-abdominal (56.9%), respiratory (20.9%), urinary (10.5%), bacteremia (3.5%), skin and soft tissue infections (2.3%); and less frequently osteoarticular infections (1,2%), febrile neutropenia (1.2%) and candidemia (1.2%). 51.2% prescriptions were considered appropriate and 48.8% inappropriate. 51 interventions were made. The type of recommendations made were de-escalate (45.1%), discontinuation (25.5%), adjust dose (11.8%), request supplementary test (11.8%) and change the antibiotic (5.8%). 86.7% of the interventions were accepted by the prescribers. Conclusion and Relevance Our study highlights the critical need to take measures to promote the proper use of antibiotics to prevent the spread of antibiotic resistance. The high percentage of accepted interventions indicates a significant level of confidence in the ASP in our hospital. Nevertheless, there is still room for improvement in this regard. References and/or Acknowledgements Conflict of Interest No conflict of interest.