{
  "abstract": "Background and Importance Antimicrobial resistance is closely linked to antibiotic overuse, particularly in Intensive Care Units (ICUs), where critically ill patients often require broad-spectrum therapy. Monitoring trends in antibiotic consumption and patient profiles is essential for optimising antimicrobial stewardship.Aim and Objectives To analyse the evolution of antibiotic and antifungal consumption and the clinical characteristics of ICU-admitted patients over the past 10 years in a secondary-level hospital.Material and Methods A retrospective observational study including drugs from ATC groups J01 (antibiotics) and J02 (antifungals) from 2015 to 2024. Consumption data were obtained from the Farmatools program, expressed as defined daily doses (DDD) per 100 patient-days. Patient data were retrieved from the ICU ENVIN registry, including demographics, admission type, APACHE score, immunosuppression status, antibiotic use, length of therapy, and empirical treatment adjustments.Results The number of patients included between 2015 and 2024 was 2706; median patient age increased (61 vs 64 years), as did APACHE scores (12.6 vs 15.1) and medical admissions (39.6% vs 62.6%),while surgical and coronary cases decreased. Immunosuppressed patients increased (9.1% vs 25.9%), whereas mortality decreased (14.4% vs 8.6%). Antibiotic use rose slightly (49.5% vs 56.8% of patients), with a total J01consumption increase from 131.5 to 148.0 DDD/100 patient-days. The most used agents were meropenem (3.9 vs 28.0), linezolid (5.9 vs 20.6), ceftriaxone(14.6 vs 15.3), piperacillin/tazobactam (11.7 vs 11.8), and vancomycin (12.3 vs9.9). For antifungals (J02), total consumption rose from 17.1 to 32.6 DDD/100 patient-days, mainly due to caspofungin (0.8 vs 7.7) and isavuconazole (introduced in 2021, 0.3 vs 7.8). Empirical therapy modifications decreased (20.4% vs 16.9%), while de-escalation after antibiogram increased (28.1% vs 61.8%). Treatment duration remained stable or slightly reduced for most agents.Conclusion and Relevance The ICU patient profile has shifted toward more medically complex and immunocompromised cases, contributing to greater overall antimicrobial use. Despite this, antimicrobial stewardship indicators improved, with shorter treatment durations and higher de-escalation rates. Continued implementation of antibiotic optimisation programs is essential, given the expected rise in patient complexity and antimicrobial demand.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Universitario Principe De Asturias, Pharmacy, Alcala De Henares, Spain"
      ],
      "name": "M Serrano"
    },
    {
      "affiliations": [
        "Hospital Universitario Principe De Asturias, Pharmacy, Alcala De Henares, Spain"
      ],
      "name": "L Cañivano Petreñas"
    },
    {
      "affiliations": [
        "Hospital Universitario Principe De Asturias, Critical Care Medicine, Alcala De Henares, Spain"
      ],
      "name": "R Molina Montero"
    },
    {
      "affiliations": [
        "Hospital Universitario Principe De Asturias, Critical Care Medicine, Alcala De Henares, Spain"
      ],
      "name": "S Gallego García"
    },
    {
      "affiliations": [
        "Hospital Universitario Principe De Asturias, Pharmacy, Alcala De Henares, Spain"
      ],
      "name": "Á Carrasco Pintor"
    }
  ],
  "title": "4CPS-145 Evolution of antibiotic consumption and ICU patient characteristics over the last decade in a secondary-level hospital",
  "uid": "63b0339d-53b2-580e-bf91-ce3a338b8dae"
}