The assessment of antimicrobial susceptibility of bacterial strains isolated from wild birds in the Danube delta biosphere reserve

had a median age of 5.1 years (IQR: 0.2-15.1)and a median length of stay of 7 days (IQR: 3.5-11).We found no significant differences in demographics and clinical characteristics by study period.We conducted 30 teleconsultations in 2024.The proportion of patients treated with at least one antibiotic was 87.7% overall, being 94.3% (33/35) in 2023 and 81.6% (31/38) in 2024 (P = 0.09).The 64 patients treated with antibiotics received 125 therapies: 64 in 2023 and 61 in 2024, with an average of 1.8 and 1.6 molecules per patient, respectively (p = 0.9).DOT/100 patient-days significantly decreased from 110.3 in 2023 to 91.5 in 2024 (p < 0.0 01); DOT/10 0 patient-days decreased for vancomycin and teicoplanin from 3.0 and 6.6 in the pre-intervention period to 1.8 and 1.3 in the postintervention period, respectively.We detected on HAI due to Pseudomonas aeruginosa in the pre-intervention periodo, and none in the post-intervention period.Discussion: This study documented a significant reduction in the use of antibiotics expressed as DOT/100 patient-days, suggesting that multidisciplinary teleconsultations were valuable in PICU patient infection disease management and appropriate use of antimicrobials.This preliminary analysis did not show a statistically significant reduction in the proportion of patients treated with at least one antibiotic in the two periods; the extension of the study period and a larger sample size could better investigate this issue.Conclusion: Teleconsultation contributed to reducing antibiotic consumption in PICU suggesting its effectiveness in the multidisciplinary management of PICU patients within an antimicrobial stewardship program.