4CPS-073 Impact of antibiotic stewardship programme (ASP) on antibiotic use and clinical outcomes in patients hospitalised with community-acquired pneumonia (CAP): pre- and post-intervention study

<h3>Background and Importance</h3> Community-acquired pneumonia (CAP) is still one of the leading causes of death worldwide. Implementation of the Antibiotic Stewardship Programme (ASP) aimed to improve the correct and responsible antibiotic use by encouraging guideline adherence. <h3>Aim and Objectives</h3> This retrospective observational before-after study aimed to evaluate whether the ASP may improve guideline adherence, antibiotic exposure and clinical outcomes in patients hospitalised with CAP in Hungary. <h3>Material and Methods</h3> The study was conducted at a Pulmonology Department of a tertiary care medical centre in Hungary. The ASP implementation (still valid) consisted of written and published guidelines available to all professionals, continuous supervision and counselling service on antibiotic therapies made by pharmacists at patient level, with the aim to ensure compliance with CAP guidelines. Overall guideline adherence (agent selection, route of administration, dose), clinical outcomes (length of stay, 30-day mortality), antibiotic exposure and direct costs were compared between the two periods. Fisher’s exact test and t-test were applied to compare categorical and continuous variables, respectively <h3>Results</h3> Significant improvement in overall CAP guideline adherence (103/148 vs. 149/194, 30.2%), sequential therapy (4/148 vs 28/194, 10.5%) and significant reduction in the total duration of antibiotic therapy (8 vs 6 days, 16%) were observed. Guideline non-adherent combination therapies with metronidazole decreased significantly by 28.1% (32/103 vs 6/194). Antibiotic exposure decreased by 23.6% (18 vs 14 DDD/patient) leading to a significant decrease of direct costs (33.2%). Length of stay decreased by 13.5% (8 vs 6 days) and 30-day survival increased by 5.9%. <h3>Conclusion and Relevance</h3> ASP may play an important role in optimising empirical antibiotic therapy in CAP having a sustained long-term effect. <h3>References and/or Acknowledgements</h3> Supported by the University of Debrecen Programme for Scientific Publication. <h3>Conflict of Interest</h3> No conflict of interest