4CPS-207 Comparative study of adherence rates to computerised injectable antibiotic protocols

<h3>Background and Importance</h3> The establishment of protocols for the prescription of injectable antibiotics (IA) is a crucial component of medication safety. Computerised antibiotic protocols (CAP) are available in our institution as a prescribing support tool. <h3>Aim and Objectives</h3> The objective is to evaluate the current adherence rate to CAP and compare it with previous data. <h3>Material and Methods</h3> A prospective collection of each IA prescription was conducted from July 2024 to August 2024 using the Pharma Class decision support system. The prescriptions were subsequently analysed using a collection grid comprising eight criteria: type of prescription, presence of a solvent, nature of the solvent, dilution volume, infusion duration, administration route, continuous or intermittent infusion modality, and frequency of administration. A comparative analysis of the results was then conducted using data collected from July 2022 to August 2022. <h3>Results</h3> Overall, CAP adherence was observed in 63% (126/200) of prescriptions in 2024 compared to 50% (109/217) in 2022, indicating a statistically significant improvement in prescription quality (p=0.0085; α=5%). The most frequently prescribed antibiotic during both study periods was ceftriaxone, with adherence rates improving from 24% (12/50) in 2022 to 68% (28/41) in 2024. Amoxicillin-clavulanate achieved a 100% adherence rate (10/10) in 2024, up from 66% (23/35) in 2022. In 2022, four departments (geriatrics, digestive surgery, dermatology, and gastroenterology) accounted for 76% of off-protocol prescriptions, reduced to only 19% in 2024. Conversely, oncology and haematology had off-protocol prescriptions in 73% (11/15) and 58% (14/24) of cases in 2024, respectively, as these departments were not included in the 2022 study. Furthermore, 99.5% of off-protocol prescriptions were non-compliant with CAP on at least one evaluation criterion in 2024, compared to 100% in 2022. <h3>Conclusion and Relevance</h3> Improvement initiatives (training, flyers, and pharmaceutical interventions) implemented since 2022 may account for the increased adherence of physicians to computerised protocols. However, the analysis of these practices has identified issues with the utilisation of these protocols, particularly in haematology (single-route infusion not allowing prolonged administration via CAP), leading to the development of an adapted protocol. Further avenues for continuous improvement, in collaboration with prescribers, need to be explored to sustain and enhance adherence to protocols and maintain the quality of IA prescriptions. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest