4CPS-047 Assessing the impact of antimicrobial stewardship programmes in hospitals: the role of pharmacists

Background and importance Antimicrobial resistance is a growing public health problem because it has been associated with increasing treatment failure, hospital stay, mortality and healthcare costs. An antimicrobial stewardship programme is a multidisciplinary team working together against inappropriate antimicrobial prescriptions. Its aim is to improve clinical outcomes and slow down the emergence of antimicrobial resistance. Pharmacists are an integral part of the stewardship team and have an important role. Aim and objectives This study aimed to assess the role of pharmacists within the antimicrobial stewardship programme in a 200 bed hospital. Secondary objectives were to analyse pharmaceutical interventions, quantify their acceptance, the recommendations made and the antimicrobial drugs involved. Material and methods We conducted a prospective observational study in a 200 bed hospital over a period of 25 months (September 2017–September2019). Inclusion criteria: patients with active antimicrobial prescriptions during admission with an antimicrobial stewardship programme recommendation. Exclusion criteria: antimicrobial stewardship programme recommendation made without active pharmacist participation. Recommendations were classified as no indication of antimicrobial treatment, inadequate antimicrobial drug selection, drug dosage, route of administration and duration of treatment. Recommendations made were prospectively registered and at 72 hours intervention acceptance was assessed based on modifications to the medical prescription. Collected data were age, gender, antimicrobial treatment, type of recommendation and acceptance. Results A total of 580 recommendations were carried out in 474 patients. The average age of the patients was 69 years (54% men). Intervention acceptance was 93% (539 recommendations were accepted). Recommendations according classifications were: 190 (33%) inadequate antimicrobial drug selection, 131 (23%) inadequate route of administration, 129 (23%) inadequate duration of treatment, 85 (15%) inadequate drug dosage and 45 (8%) no indication for antimicrobial treatment. Conclusion and relevance Pharmacist recommendations were about drug selection, route of administration, drug dosage, duration of treatment and absence of indication of treatment, with a high degree of acceptance. Hence pharmacists can play an important role in antimicrobial stewardship programmes. It seems reasonable to claim that antimicrobial stewardship programme recommendations may enhance the degree of acceptance when decisions are made from a multidisciplinary team. References and/or acknowledgements 1. https://www.eahp.eu/practice-and-policy/antimicrobial-resistance 2. Int J Clin Pharm 2018;40:948–952. doi: 10.1007/s11096-018-0675-z. No conflict of interest.