192. Impact of an Intervention to Reduce Inappropriate Use of Antibiotics in Asymptomatic Bacteriuria
Session: Poster Abstract Session: Antibiotic Stewardship
Friday, October 21, 2011
Room: Poster Hall B1
Background: Hospitalized patients with asymptomatic bacteriuria (ASB) are often treated with an antibiotic even if the treatment is unlikely to confer any clinical benefit. We conducted a prospective study in two teaching hospitals to evaluate the impact of an intervention aimed at reducing inappropriate antimicrobial therapy.

Methods: All patients > 18 years old admitted between Jan 10 and Mar 4, 2011 who had a positive urine culture and were asymptomatic were included. Indications for treatment were based on published clinical guidelines and validated by two physicians. An intervention was realized by a pharmacist when antimicrobial therapy was initiated for ASB without being indicated.

Results: 71 patients were included. Patients mean age was 71 years and 84,5% (60/71) were female. Most patients were hospitalized in surgery, orthopedics and obstetrics/gynecology wards. A treatment was initiated in 44 patients (62%). Co-trimoxazole was the most often prescribed antibiotic (n=24; 54%), followed by ciprofloxacin (n=9; 20%). Among those patients, inappropriate use of antibiotics was observed in 24 (54%). Recommendations to discontinue (D/C) the antibiotics were accepted in 10/24 patients (42%). The reasons for the refusal were diverse. Among the 14 interventions to D/C antibiotic treatment that were not accepted, treatment was however modified in 7 patients (50%). A total of 96 doses of antibiotics were saved by the interventions, and there was a reduction of 42% in the number of patients treated inappropriately with antibiotics.

Conclusion:A significant proportion of ASB are still treated, despite of any clear indication. Intervention of a pharmacist can have a significant impact to decrease inappropriate use of antibiotics.


Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Jessica Demers, B.Pharm.1,2, Marilyn Hudon, B.Pharm.1,2, Luc Bergeron, B.Pharm, M.Sc.2,3, François Brouillette, B.Pharm, M.Sc.1 and Jean Lefebvre, B.Pharm., PhD2, (1)Pharmacy, C.H. Universitaire de Québec, Québec, QC, Canada, (2)Faculty of pharmacy, Université Laval, Québec, QC, Canada, (3)Pharmacy dept., C.H. Universitaire de Québec, Québec, QC, Canada

Disclosures:

J. Demers, None

M. Hudon, None

L. Bergeron, None

F. Brouillette, None

J. Lefebvre, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.