Rocío Morante (Spain)
HOSPITAL 12 OCTUBRE Pediatric SurgeryAuthor Of 1 Presentation
IMPACT IN ANTIBIOTIC USE AFTER IMPLEMENTATION OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM AND A JOINT PROTOCOL WITH ELECTRONIC PRESCRIPTION FOR APPENDICITIS/PERITONITIS IN PEDIATRICS
Abstract
Backgrounds:
Initial antibiotic treatment in appendicitis/peritonitis significantly reduces wound infection and intra-abdominal abscess formation in patients with gangrenous or perforated appendicitis. Randomized controlled trials have shown that the use of lower-spectrum antibiotic combinations is as effective in preventing abscesses or surgical wound infections as broad-spectrum regimens.
Methods
Observational, retrospective study of patients <16 years of age admitted for appendicitis and/or peritonitis from Jan/2014 to Dec/2019 in a tertiary university hospital in Madrid, Spain. Three study periods were established: P1 2014-2015 (before Antimicrobial Stewardship Programme (ASP)), P2 2016-2018 (ASP implemented) and P3 Jan/2019-Dec/2019 (ASP and implementation of an appendicitis/peritonitis protocol with electronic prescription, including lower-spectrum antibiotic combinations and selected and clinically guided use after surgery). Antimicrobial use was analysed with the days of therapy/1000 admissions days (DOT/1000) and start of treatment/1000 hospital admissions (SOT/1000).
Results:
During the study period a total of 1619 patients met inclusion criteria. The proportion of patients without antibiotic therapy after surgery during P1, P2 and P3 was 5.6%, 3.7%, and 38.6% respectively. [C1] The evolution of antibiotic use expressed by DOT / 1000 is shown in Figure 1. SOT/1000 of ampicillin, gentamicin and metronidazole rose from 162, 190 and 190 in 2014 to 386, 402 and 409 in 2019. DOT/1000 of meropenem drop to 64.85 in 2014 to 0 in 2019.
Conclusions/Learning Points:
The implementation of an ASP and a low-spectrum antibiotic protocol with electronic prescribing, reduced the antimicrobial use in children with appendicitis/peritonitis. The proportion of patients without antibiotic therapy after surgery increased and the use of carbapenems and other broad-spectrum antibiotics was reduced after the intervention. These improvements were observed when an electronically available protocol was added to the ASP implementation.
Poster Author Of 2 e-Posters
PD091 - CLINICAL IMPACT AFTER IMPLEMENTATION OF AN ANTIMICROBIAL STEWARDSHIP PROGRAM AND A JOINT ELECTRONIC PROTOCOL FOR THE MANAGEMENT OF PATIENTS WITH APPENDICITIS AND/OR PERITONITIS IN PEDIATRICS (ID 775)
- Serena Villaverde (Spain)
- Patricia Brañas (Spain)
- José Manuel Caro (Spain)
- Rocío Morante (Spain)
- Irene Gómez (Spain)
- Gloria Mirete (Spain)
- Cinta Moraleda (Spain)
- Daniel Blázquez-Gamero (Spain)
- Angela Manzanares (Spain)
- David Torres (Spain)
- Elisa Fernandez (Spain)
- Luis Prieto (Spain)
- Pablo Rojo (Spain)
- Cristina Epalza (Spain)