5PSQ-110 Antibiotic stewardship in an emergency department

<h3>Background and Importance</h3> Antimicrobial resistance represents one of the foremost health challenges of our time. The implementation of a regional antibiotic policy and a reduction in the use of broad-spectrum antibiotics are seen as key solutions. However, recent data from emergency department (ED) still indicate inappropriate use of antibiotics. <h3>Aim and Objectives</h3> This study aims to investigate the adherence to the regional antibiotic policy in empirical antibiotic choices for intravenous administration. <h3>Material and Methods</h3> Records of adult patients admitted between May and August 2023 were screened. For patients undergoing antibiotic treatment, the following data were recorded: gender, age, admission diagnosis, antibiotic, dosage, and frequency. The last three parameters were employed to evaluate the empirical antibiotic choice in accordance with the regional guidelines. Subsequently, data were categorised into three groups: ‘Green’ (appropriate empirical treatment); ‘Yellow’ (suboptimal empirical treatment); and ‘Red’ (empirical treatment with a broader spectrum than necessary according to indication). <h3>Results</h3> A total of 53 individual patient records were screened (51% male, n=27), of which approximately 70% of the patients were over 70 years-old. Based on the selected categories, the empirical antibiotic choices were distributed as follows: 60% (n=32) in ‘Green’; 19% (n=10) in ‘Yellow’; and 21% (n=11) in ‘Red’. The categorisation as ‘Yellow’ was attributed to the absence of a macrolide in combination therapy for 50% (n=5), while the remaining 50% were due to insufficient antimicrobial spectrum/dosage, or lack of combination therapy. The ‘Red’ categorisation was assigned to 45% (n=5) of cases due to deviation from the first-line recommendation of intravenous ampicillin/gentamicin. For patients diagnosed with infection without a known focus, 46% (n=6) were classified as ‘Red’. In cases of pneumonia without COPD or asthma, 43% (n=3/7) fell into the ‘Red’ category. These two diagnoses demonstrated the lowest levels of guideline adherence. For sepsis, only one patient (17%) was classified outside the ‘Green’ category. <h3>Conclusion and Relevance</h3> This study demonstrates that 40% of empirical antibiotic choices in the ED were not in accordance with the established regional antibiotic policy. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest