AS01.d. Antibiotic Stewardship

PD101 - MICROBIOLOGICAL CHARACTERIZATION OF CLINICAL ISOLATES IN PEDIATRIC APPENDICITIS DURING AN ANTIMICROBIAL STEWARDSHIP PROGRAM IN A TERTIARY HOSPITAL IN MADRID, SPAIN (ID 778)

Session Name
0330 - Poster Discussion Session 05: Antimicrobials & Antibiotic Stewardship (ID 6)
Presenter
Authors

Abstract

Backgrounds:

Appendicitis represents the most common abdominal surgical emergency in the pediatric age group and it is responsible of a high use of antibiotics. Antimicrobial stewardship programs (ASP) have shown effectiveness in reducing antimicrobial use in adults, but data on pediatric population are limited.

Methods

Retrospective study in a children tertiary hospital between 2016-2018 (only-ASP period) and 2019 (adding creation of protocol with computerized access: amoxicillin/clavulanate at diagnosis, ampicillin + gentamicin + metronidazole at induction only continued for complicated appendicitis). Bacterial epidemiology and susceptibility patterns were compared between the 2 periods, and microorganisms involved in post-operative complicated vs. uncomplicated appendicitis.

Results:

From 1098 patients, 68.9% samples were processed, from which, 41,6% yielded a positive culture. Microorganisms isolated are shown in table 1. Antibiotic susceptibility rates were: 41,9% for ampicillin in E. coli; 91,0% and 88,2% for gentamicin, 91,0% and 97,1% for ciprofloxacin, in E. coli and P. aeruginosa, respectively; and 100% for metronidazole in B. fragilis. No multi-drug resistant microorganisms were found and only 4 ESBL-E. coli producers were isolated. Complications after surgery occurred in 22.2% of cases with positive culture. Fifty-nine episodes took place during only-ASP period (p=0.039). No statistical differences were observed in post-operative complicated vs. uncomplicated appendicitis related to patients or microorganisms variables.captura de pantalla 2022-01-09 a las 12.30.09.png

Conclusions/Learning Points:

We found low resistant antibiotic rates in appendicitis in children from 2016 to 2019. Bacteria and susceptibility patterns are similar in the two study periods and in post-operative complicated and not-complicated appendicitis. It suggests that complications are not so much related to the microorganisms involved or to a wrong empirical treatment received as probably to the control of the focus or the utilization of ASP protocols with computerized access for patient management.

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