4CPS-213 Impact of the antimicrobial stewardship programme on antibiotic consumption in two internal medicine units

<h3>Background and Importance</h3> Antimicrobial Stewardship Programs (ASPs) are essential to improve clinical outcomes and reduce antimicrobial resistance, a growing public health issue. In the current context, their implementation is critical. <h3>Aim and Objectives</h3> Compare antimicrobial consumption (DDD per 100 bed days) between two Internal Medicine units (A <i>vs</i>.B) of the same healthcare complex, but physically separated. Unit-A has the presence of an ASPs team. <h3>Material and Methods</h3> Observational and retrospective study conducted in a public tertiary care hospital with 888-beds (average length of stay =6.6 days; occupancy rate =70.3%). Two Internal Medicine units (A <i>vs</i>.B) were analysed with the following characteristics: beds=174 (<i>vs</i>.94); average length of stay=8.7 days (<i>vs</i>.8.4); occupancy rate=70% (<i>vs</i>.84.88%), mortality rate per number of admissions=11.9% (<i>vs</i>.14.2%). <h3>Antimicrobial consumption (groups</h3> J01-J04) was analysed (years: 2021–2023). Consumption data were obtained from the Pharmacy Management System and hospitalisation indicators from the Admissions Service. The ATC/DDD system of the World Health Organization was adopted, using DDD values established for 2023. The measure used was DDD/100-bed days, and de consumption trend was compared; the differences between the two units were evaluated using Chi-squared test (p-value=0, 1). <h3>Results</h3> Antimicrobials overall consumption (DDD/100B) increased in both units, but it was greater in unit-B. Also, the increase by spectrum was more pronounced in B. These differences were significant in overall consumption (p=0.001) and anti-pseudomonal antimicrobials consumption (p=0.078). In 2023, the most commonly used antibacterials (DDD/100B Unit-A <i>vs</i>.Unit-B) were: ceftriaxone (25,87 <i>vs</i>.26,27), piperaciclin/tazobactam (12,12 <i>vs</i>.12,11), amoxicilin/clavulanic acid (8,71 <i>vs</i>.13,81) and levofloxacin (6,39 <i>vs</i>.9,23). <h3>Conclusion and Relevance</h3> There are quantitative and qualitative differences in the use of antimicrobials between the units, with more appropriate use in unit-A. Although the origin of these differences may be multifactorial, the presence of a multidisciplinary ASPs team (Unit-A) appears to have a positive impact on optimising antimicrobial consumption. It is essential to implement ASPs in all hospital units to improve clinical outcomes, ensure cost-effective and safe use, and reduce antimicrobial resistance. <h3>References and/or Acknowledgements</h3> WHO Collaborating Centre for Drug Statistics Methodology. Available from https://www.whocc.no/atc_ddd_methodology/who_collaborating_centre/ <h3>Conflict of Interest</h3> No conflict of interest