4CPS-018 Evolution of antimicrobial use in COVID-19 patients

Background and ImportanceAntimicrobial prescribing prevalence in COVID-19 patients is estimated to be around 75%, whereas bacterial coinfection prevalence is estimated to be less than 10%. This data shows the unnecessary use of antibiotics.Aim and ObjectivesTo compare the evolution of antimicrobial consumption in COVID-19 patients between the beginning of the pandemic and the third COVID-19 wave in our hospital.Material and MethodsObservational retrospective study conducted in a tertiary care hospital during March to June 2020 and May to August 2021 in COVID-19 Intensive Care Unit (CICU) and COVID-19 medical ward (CMW) patients. We extracted antimicrobial consumption data from the Pharmacy database (Silicon) and bed-days data from Admission Service.We standardised antimicrobial consumption to defined daily doses (DDD)/100 bed-days. The descriptive analysis was performed with SPSS. We conducted a normality, an independence and a correlation test.ResultsAn 8% decrease in global antimicrobial use was observed. However, we found a 30% decrease in CMW, and a 39% increase in CICU.Abstract 4CPS-018 Table 1 MARCH-JUNE 2020 MAY-AUGUST 2021 EVOLUTION 2020- 2021 CICU CMW GLOBAL CICU CMW GLOBAL CICU CMW GLOBAL BED-DAYS 573 2346 2919 493 2114 2607 Co-amoxiclav DDD/100BED-DAYS 0,9 22 17,9 1,2 21,1 17,3 +0,3 (33,3%) -0,9 (-4%) -0,6 (-3,4%) 3rd generation cephalosporins DDD/100BED-DAYS 32,3 8,9 13,5 35,7 3,5 9,6 +3,4 (10,5%) -5,4 (-60%) -3,9 (-28,9%) Antipseudomonal antibiotics DDD/100BED-DAYS 16,1 9,1 10,5 27,8 5,9 10 +11,7 (72,7%) -3.2 (-35.1%) -0,5 (-4,%) Quinolones DDD/100BED-DAYS 2,3 3,6 3,4 10,8 1,4 3,2 +8,5 (370%) -2,2 (-61,1%) -0,2 (-5,9%) Anti-MRSA antibiotics DDD/100BED-DAYS 23,4 3,4 7,3 18,6 2 5,1 -4,8 (-20,5%) -1,4 (-41,2%) -2,2 (-30,1%) Antifungal treatments DDD/100BED-DAYS 4,4 1 1,6 22,9 0 4,4 +18,5 (420%) -4,4 (-100%) +2,8 (175%) Total antimicrobial consumption DDD/100BED-DAYS 135,1 62,6 76,8 187,3 43,7 70,8 +52,2 (38,6%) -18,9 (-30,2%) -6 (-7,8%) The antibiotic use in the two periods showed a significance correlation (p