4CPS-159 Analysis of the interventions carried out in the geriatric service in collaboration with the internal medicine and microbiology services

Background and Importance Controlling the prescription of antibiotics is important for better patient care and reducing the emergence of resistance. Aim and Objectives Analysing the interventions carried out on patients admitted to the geriatric service from the antimicrobial use optimisation programme (PROA) of our hospital and evaluating the degree of acceptance. Material and Methods Observational, descriptive and prospective study of the interventions carried out by the PROA team (pharmacists, internists and microbiologists) to patients admitted to the Geriatrics service in the period between January 2022 and March 2023. All patients with any prescribed antimicrobial were included, reviewing their daily clinical evolution during the duration of treatment. The data collected were: sex, age, analytical values, antimicrobials prescribed, interventions performed and acceptance of them. The types of interventions were classified as empirical treatment adjustment, targeted treatment adjustment, end of treatment and renal function adjustment. Data were obtained from the inpatient electronic prescribing programme and the electronic health record. Data were processed by Microsoft Excel software. Results During the study period, a total of 840 patients with a mean age of 90 years (±4 SD) were admitted to the geriatrics service and they started antimicrobial treatment. A total of 180 interventions were carried out, 158 (87.78%) were accepted. Empirical treatment adjustment was suggested in 8.34% (15/180), targeted treatment adjustment in 28.33% (51/180), treatment completion in 30% (54/180) and a dosage adjustment based on renal function in 33.33 (60/180). Among the most notable interventions would be meropenem, with 24 interventions carried out, 83.33% were accepted; and piperacillin-tazobactam, with 24 interventions and with an acceptance rate of 79.17%. Although in a lower percentage, we also found other high-impact antimicrobials, such as linezolid, with nine interventions and an acceptance rate of 77.78%; and ceftazidime-avibactam, with six interventions performed and all of them were accepted. Conclusion and Relevance With such prominent data regarding acceptance, the training and value of the pharmacist's role within the multidisciplinary team formed in collaboration with Internal Medicine and Microbiology is demonstrated. Furthermore, the importance of the existence of antimicrobial use optimisation programmes in the hospital setting is highlighted, showing how the inappropriate use of certain high-impact medications is reduced, achieving a decrease in the appearance of resistance. References and/or Acknowledgements Conflict of Interest No conflict of interest.