{
  "abstract": "Background and Importance The implementation of antimicrobial stewardship programmes (ASPs) is recognised as a priority to reduce infections caused by multidrug-resistant bacteria. Emergency departments (EDs) are among the most critical settings for implementing ASPs.Aim and Objectives To assess antibiotic consumption and the appropriateness of antibiotic prescriptions in the ED of a tertiary care hospital.Material and Methods Retrospective observational study conducted at a tertiary care hospital, assessing the evolution of ASP indicators in the ED over a three-year period (2022 – 2024).Some of the indicators defined in the ASP panel for EDs, published in Farmacia Hospitalaria,1 were selected and assessed. Consumption indicators included: defined daily doses per 1000 discharges (DDD/1000) of antibiotics (J01), carbapenems, fluoroquinolones, macrolides, third-generation cephalosporins (3GC) and anti-MRSA agents (vancomycin, daptomycin, teicoplanin, linezolid), as well as the amoxicillin-clavulanate (AC)/piperacillin-tazobactam (PTZ) ratio. Appropriateness indicators included:% of community acquired pneumonia (CAP) cases treated with amoxicillin, AC and fluoroquinolones;% of urinary tract infections (UTIs) treated with fosfomycin trometamol, AC and fluoroquinolones; and% of chronic obstructive pulmonary disease (COPD) exacerbations treated with AC and fluoroquinolones.Results Total antibiotic consumption, expressed as DDD/1000, was 176.54 (2022), 179.01 (2023) and 170.26 (2024). By antibiotic class, DDD/1000 were 9.00, 9.46 and 9.71 for carbapenems; 21.94, 19.16 and 16.93 for fluoroquinolones; 13.14, 14.22 and 15.42 for macrolides; 35.42, 34.52 and 33.63 for 3GC; and 5.52, 6.05 and 6.55 for anti-MRSA agents. The AC/PTZ ratio was 3.83, 4.28 and 4.83.Regarding prescription appropriateness, 18.18%, 13.19% and 22.90% of CAP cases were treated with amoxicillin; 42.42%, 47.25% and 41.22% with AC; and 28.79%, 28.57% and 25.95% with fluoroquinolones. For UTIs, 18.65%, 18.18% and 25.68% were treated with fosfomycin trometamol; 16.08%, 13.42% and 11.67% with fluoroquinolones; and 4.82%, 6.49% and 3.89% with AC. For COPD exacerbations, 48.15%, 36.84% and 36.36% were treated with AC; and 42.59%, 47.37% and 41.82% with fluoroquinolones.Conclusion and Relevance Global antibiotic consumption in the hospital ED remained stable during the study period.Targeted interventions are needed to optimise fluoroquinolone prescribing for respiratory infections.References and/or Acknowledgements 1. Ruiz-Ramos J, Santolaya-Perrín MR, González-Del-Castillo J, Candel FJ, et al. Design of a panel of indicators for antibiotic stewardship programs in the emergency department. Farm Hosp. 2024 ;48(2):T57–T63.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "H Josep Trueta, Pharmacy Department, Girona, Spain"
      ],
      "name": "C Subirana Batlle"
    },
    {
      "affiliations": [
        "H Josep Trueta, Pharmacy Department, Girona, Spain"
      ],
      "name": "C Toro Blanch"
    },
    {
      "affiliations": [
        "H Josep Trueta, Pharmacy Department, Girona, Spain"
      ],
      "name": "L Gratacós Santanach"
    },
    {
      "affiliations": [
        "H Josep Trueta, Pharmacy Department, Girona, Spain"
      ],
      "name": "M Vila Currius"
    },
    {
      "affiliations": [
        "H Josep Trueta, Emergency Department, Girona, Spain"
      ],
      "name": "MÀ Gispert Ametller"
    },
    {
      "affiliations": [
        "H Josep Trueta, Pharmacy Department, Girona, Spain"
      ],
      "name": "Y Ortuño Ruiz"
    },
    {
      "affiliations": [
        "H Josep Trueta, Pharmacy Department, Girona, Spain"
      ],
      "name": "E Martinez Diaz"
    },
    {
      "affiliations": [
        "H Josep Trueta, Pharmacy Department, Girona, Spain"
      ],
      "name": "C Quiñones Ribas"
    }
  ],
  "title": "4CPS-212 Antibiotic consumption and utilisation patterns in an emergency department: what can we improve?",
  "uid": "08376d48-5a17-5b41-85c1-f2f0a335a987"
}