187. Impact of antimicrobial stewardship program in a care teaching institution  of high complexity in Colombia
Session: Poster Abstract Session: Antibiotic Stewardship
Friday, October 21, 2011
Room: Poster Hall B1
Background: 

The increase in antimicrobial resistance and inappropriate use of antibiotics have been led a global alert and our institution, a center of high complexity and reference transplant in Colombia, is no exception. 

Methods: 

We implemented a antimicrobial stewardship  from 2008, called participative strategy. Our goal is to evaluate the impact on antibiotic use and antimicrobial resistance. We create a database on the intranet powered continuously by pharmacy and microbiology. The surveillance was performed in 4 groups of antibiotics; glycopeptides, carbapanems, quinolones and third generation cephalosporins. Pharmaceutical chemists reported the initiation of antibiotics and microbiology laboratory reportsmultidrug resistant organisms (MDROs). The infectious disease specialists evaluated daily by patients or medical records to identify the appropriateness of antibiotic use and make recommendations on both the history and personal discussion with physicians. The formulation of antibiotics was not restricted. 

Results: 

Between January 2008 and December 2010, 6088 interventions were performed. 34.7% were vancomycin, 34.1% to carbapenems, quinolones, 20.8% and 3.6% for cephalosporins third generation.  The opportunity assessment after formulation was 1.5 days  (1.2 days in adults and 2.3 days in children). Appropriate empirical treatment increased from 63.2% to 75% and appropriate targeted therapies increased from 88.2% to 90.6%. Acceptance of recommendations by physicians was 85%. Antibiotic consumption in Defined Daily Doses (DDD) per 1000 patient days in ICU had the following changes: carbapenems passed from 284 to 199, vancomycin 163 to 90, Quinolones from 266 to 207 and third-generation cephalosporins from 48 to 11 . Institutional epidemiology  shows a down ward trend in the percentage of MDROs germs

Conclusion: 

Our strategy, which enables the active participation of the prescriber without restricting the use of antibiotics is effective in reducing the consumption of antibiotics and hospital costs per formulation. The institutional impact on the epidemiology we can define subsequently be a follow-up period where the implemented techniques in microbiological identification are the same.


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

Franco Montufar, MS, MSSc1, Carlos Ignacio Gomez, MD, MSSc2, Ana Correa, MD, MSSc1, John Zuleta, MD, MSSc3, Isabel Critina Ramirez, MD, MSSc4, Andrea Restrepo, MD, MSSc4, Monica Trujillo, MD, MSSc4, Carlos Garces, MD, MSSc4, Monica Valderrama4, Alejandra Maria Restrepo, MD4 and Ana Maria Bedoya, MD4, (1)Internal Medicine, Hospital Pablo Tobon Uribe, Medellin, Colombia, (2)Internal Medicine, Hospital Pablo Tobón Uribe, Medellín, Colombia, (3)Clinical Investigation Group , Hospital Pablo Tobon Uribe, Medellin, Colombia, (4)Hospital Pablo Tobón Uribe, Medellín, Colombia

Disclosures:

F. Montufar, None

C. I. Gomez, None

A. Correa, None

J. Zuleta, None

I. C. Ramirez, None

A. Restrepo, None

M. Trujillo, None

C. Garces, None

M. Valderrama, None

A. M. Restrepo, None

A. M. Bedoya, 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.