4CPS-089 Impact of the antimicrobial stewardship programme’s recommendations on the annual consumption of carbapenems

<h3>Background and Importance</h3> The complexity of infectious diseases and the increase in resistance make it necessary to establish antimicrobial stweardship programmes (ASP). <h3>Aim and Objectives</h3> To analyse the interventions carried out by the ASP on the consumption of carbapenems in a regional hospital. <h3>Material and Methods</h3> Observational study of the interventions carried out by the ASP on treatments with meropenem, ertapenem and imipenem throughout the year 2023. Variables analysed were: indication, empirical vs directed treatment, type of recommendation and acceptance or not of the intervention. The impact of the recommendations was correlated with antibiotic consumption, through the defined daily doses (DDD)/100 bed-days and their comparison with those of the previous year. <h3>Results</h3> During the study period, 129 interventions were carried out on carbapenem treatments, of which 45.7% were on meropenem, 53.5% on ertapenem and 0.8% on imipenem.The main indications for meropenem were respiratory infection (30.5%) and bacteraemia (25.4%). It was targeted therapy in 25% of the cases. The recommendations made were to maintain treatment (40.7%), de-escalate (27.1%), adjust duration (27.1%) and suspend (5.1%). They were fulfilled in 90% of the cases. Annual consumption during 2023 was 884.17 DDD/100 bed-days, achieving a decrease of 16% compared to the previous year (1052.36).The main indications for ertapenem were urinary infection (55.7%) and respiratory infection (17.4%). 59.4% of the cases were targeted therapy. Recommendations were to maintain treatment (31.9%), de-escalate (31.9%), adjust duration (27.5%) and suspend (8.7%). They were fulfilled in 80% of the cases. Annual consumption during 2023 was 1273.5 DDD/100 bed-days, representing an increase of 7% compared to 2022 (1183.33).There was a prescription for empirical imipenem to treat respiratory infection, in which de-escalation of treatment was recommended, but it was not accepted. Annual consumption during 2023 was 12.5 DDD/100 bed-days, achieving a decrease of 73% compared to the previous year (46.75). In global terms, the consumption of carbapenems during 2023 was 2170.16 DDD/100 bed-days, achieving a reduction of 4.21% compared to 2022 (2265.63). <h3>Conclusion and Relevance</h3> Ertapenem is mainly prescribed as a targeted antibiotic whereas meropenem is used empirically. Global consumption of carbapenems has decreased compared to the previous year. The interventions of ASP are essential in the reduction of broad-spectrum antibiotics. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest