{
  "abstract": "Background and Importance The intervention of a Antimicrobial Stewardship teams is useful in optimising antibiotic therapy in order to avoid antibiotic resistance.Aim and Objectives To assess whether the 2016 ASTs (Antimicrobial Stewardship Program) intervention in a gastroenterology department continues to impact antimicrobial use patterns in 2023 and resistance profiles of pathogens involved in biliary-origin bacteraemia.Material and Methods This is a retrospective observational study comparing antimicrobial use and isolated microorganisms in 120 patients with biliary-origin bacteraemia between 2017 and 2023. The study was conducted in a 30-bed gastroenterology department of a tertiary public hospital with 888 beds, an average stay of 6.6 days, and a 70.3% occupancy rate. Antimicrobial consumption (ATC J01-J04 groups and metronidazole) was measured in defined daily doses (DDDs) per 100 bed-days (DDDs/100BD) using the WHO ATC/DDD system for 2023. Data were sourced from the Pharmacy Management System, Admission Service, and the ASTs team’s microbiological database.Results Total antimicrobial use increased slightly from 73.7 DDDs/100BD in 2017 to 77.5 DDDs/100BD (+5%) in 2023. The most frequently used antimicrobials in both years were ceftriaxone (11.9/19.2 DDDs/100BD), piperacillin/tazobactam (7.7/11.5), metronidazole (15/10.3), ciprofloxacin (9.9/8.8), amoxicillin/clavulanate (8.8/4.5), and meropenem (1.7/4), representing 74.5% and 75.2% of total consumption, respectively. The average hospital stay decreased by 7.5%, from 6.7 days in 2017 to 6.2 in 2023, while mortality decreased by 4% (3% vs 2.9%). Positive blood cultures increased from 73 to 120 (+64%). Notably, there were low rates of extended-spectrum beta-lactamase (ESBL) Gram-negative bacteria and methicillin-resistant Gram-positive organisms.Conclusion and Relevance The positive impact of the 2016 ASTs intervention on antimicrobial consumption has persisted in 2023, with stable global usage and a predominant use of narrow-spectrum antibiotics such as ceftriaxone. The optimisation of antimicrobial use has not negatively affected hospital stay or mortality rates. Resistance rates have remained low, despite an increase in biliary-origin bacteraemia. The rise in piperacillin/tazobactam and meropenem use was not justified by the microbiological resistance profile. ASTs programs contribute to safe antimicrobial use, extending their efficacy and minimising resistance emergence. Ongoing monitoring is essential to evaluate the long-term impact of ASTs interventions.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Complejo Asistencial Universitario De León, Hospital Pharmacy, León, Spain"
      ],
      "name": "D Ozcoidi"
    },
    {
      "affiliations": [
        "Complejo Asistencial Universitario De León, Hospital Pharmacy, León, Spain"
      ],
      "name": "M Saez Villafañe"
    },
    {
      "affiliations": [
        "Complejo Asistencial Universitario De León, Hospital Pharmacy, León, Spain"
      ],
      "name": "A Fernández Vázquez"
    },
    {
      "affiliations": [
        "Complejo Asistencial Universitario De León, Hospital Pharmacy, León, Spain"
      ],
      "name": "J Ayala Álvarez Canal"
    },
    {
      "affiliations": [
        "Complejo Asistencial Universitario De León, Hospital Pharmacy, León, Spain"
      ],
      "name": "M Flores Fernández"
    },
    {
      "affiliations": [
        "Complejo Asistencial Universitario De León, Hospital Pharmacy, León, Spain"
      ],
      "name": "L Mira Bayón"
    },
    {
      "affiliations": [
        "Complejo Asistencial Universitario De León, Hospital Pharmacy, León, Spain"
      ],
      "name": "M Barba Llacer"
    },
    {
      "affiliations": [
        "Complejo Asistencial Universitario De León, Hospital Pharmacy, León, Spain"
      ],
      "name": "R León Sánchez"
    },
    {
      "affiliations": [
        "Complejo Asistencial Universitario De León, Hospital Pharmacy, León, Spain"
      ],
      "name": "I Rodríguez Chas"
    },
    {
      "affiliations": [
        "Complejo Asistencial Universitario De León, Hospital Pharmacy, León, Spain"
      ],
      "name": "JC Saez Hortelano"
    },
    {
      "affiliations": [
        "Complejo Asistencial Universitario De León, Hospital Pharmacy, León, Spain"
      ],
      "name": "JJ Ortiz De Urbina González"
    }
  ],
  "title": "4CPS-116 Impact of a antimicrobial stewardship teams (ASTs) intervention on antimicrobial use and microorganism isolated in biliary-origin bacteraemias",
  "uid": "2a816c8e-8b8c-51f7-94ae-fd5b21af600f"
}