4CPS-042 Pharmacist’s mission in infection management: evaluation of improvement actions

Background and importanceAntibiotic (ATB) resistance is a global scourge. The WHO has established an action plan to combat ATB resistance. Pharmacists in our hospital decided to follow this action plan and optimise the use of ATB.Aim and objectivesThe purpose of the study was to determine if actions implemented by pharmacists in collaboration with an infectious disease specialist improved the correct use of ATB.Material and methodsAll care services in our hospital were involved in this retrospective study. Patients treated with antibiotics were included randomly. Pharmacists and infectious disease specialists checked inpatient records and prescriptions with an assessment form. An average comparison test (n>30; alpha 0.05) comparing each item average before and after implementation of the improvement actions was carried out.ResultsA pharmacist was integrated into infectious risk management. A commission of ATB was created. A pharmacist specialised in antibiotics was identified: he analysed ATB consumption and alerted prescribers in the event case discrepancies with the recommendations. Prescription software was set up so that initial treatment duration of ATB was limited to 4 days to promote re-evaluation of ATB. For ATB treatment >7 days, justification was requested. This retrospective study was conducted on 34 inpatient files in 2016 before implementation of the measures and compared with 34 other inpatient files in 2019 after implementation of the improvement actions. The results showed a statistically significant improvement in some criteria: ATB in accordance with recommendations 70% in 2016 and 91% in 2019 (70% vs 91%); ATB re-evaluation 75% versus 82%; and de-escalation 29% versus 69%. There was a reduction in inpatient files for: justification of an ATB treatment (100% vs 91%), clinical course during ATB treatment (100% vs 76%) and interpretation of microbiological examinations (80% vs 70%). In 2019, 82% of ATB therapies with a duration >7 days were justified in the inpatient files.Conclusion and relevanceThe actions of pharmacists improved the use of ATB in our hospital. There was a difference between the pre- and post-implementation phases over 3 years. However, during these 3 years, pharmacists made prescribers aware of the correct use of ATB. Pharmacists can improve the use of ATB through education and warning actions for prescribers.References and/or acknowledgementsNo conflict of interest.