{
  "abstract": "Background and Importance Early and adequate empiric antibiotic therapy is essential in the treatment of pneumonia and sepsis and may influence the clinical outcome.Aim and Objectives This retrospective before-after study aimed to appraise the impact of local ASP (written guidelines and antibiotic restriction) on antibiotic (AB) use and clinical outcomes in patients requiring intensive care due to pneumonia and sepsis.Material and Methods This study was conducted as a single-centre retrospective observational study in the ICU of a pulmonology department of a tertiary care centre. Data collection for the pre-intervention period occurred from 1 January 2018 to 31 May 2022, while the ASP period data was collected from 1 June to 28 March 2024.Results The patients admitted to the ICU with pneumonia and sepsis were mainly men (58/101, 57.4% and 84/128, 65.6%), the need for intensive care increased with age, and most of the patients belonged to 65+ age group in both study phases (68.3% and 58.6%). The majority of the patients had four or more comorbidities (57.4% and 40.6%). In-hospital mortality was relatively high (42.6% and 41.4%), most of the patients losing their lives already in the ICU (33/43, 76.7% and 37/53, 69.8%). Significant increase in guideline-adherent agent selection (34.5%) and use of combination therapy (35.0%) was observed, while the use of fluoroquinolones decreased significantly (-31.1%). Despite the significant decrease in the number of patients using restricted ABs (-53.3%), a significant increase was observed in the average AB exposure (form median 2.0 to 2.7 DDD/patient/day) and direct AB costs (10.5%) in the ICU. The inappropriate AB therapy was relatively low in the presence of MDRs in both phases (5.9% and 15%). However, the decrease in the use of restricted ABs and the increase in AB exposure/patient/day in the ICU were not associated with worse clinical outcomes.Conclusion and Relevance ASP implementation in the ICU resulted in a significant improvement in the appropriate use of ABs, but a significant increase in the AB exposure/patient/day. Although, all these have not been accompanied by better clinical outcomes, ASP may hold the promise to improve AMR with a sustained long-term effect.References and/or Acknowledgements Supported by the University of Debrecen Program for Scientific Publication.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "University of Debrecen, Faculty of Pharmacy Department of Pharmacology, Debrecen, Hungary"
      ],
      "name": "Z Szilágyi"
    },
    {
      "affiliations": [
        "University of Debrecen, Faculty of Pharmacy Department of Pharmacology, Debrecen, Hungary"
      ],
      "name": "Z Beniczky"
    },
    {
      "affiliations": [
        "University of Debrecen, Faculty of Medicine- Department of Pulmonology, Debrecen, Hungary"
      ],
      "name": "A Vaskó"
    },
    {
      "affiliations": [
        "University of Debrecen, Faculty of Pharmacy Department of Pharmacology, Debrecen, Hungary"
      ],
      "name": "E Varga"
    },
    {
      "affiliations": [
        "University of Debrecen, Faculty of Pharmacy Department of Pharmaceutical Technology, Debrecen, Hungary"
      ],
      "name": "I Bácskay"
    },
    {
      "affiliations": [
        "University of Debrecen, Faculty of Pharmacy Department of Pharmacology, Debrecen, Hungary"
      ],
      "name": "I Lekli"
    },
    {
      "affiliations": [
        "University of Debrecen, Faculty of Medicine- Department of Emergency Care and Oxyology, Debrecen, Hungary"
      ],
      "name": "S Somodi"
    },
    {
      "affiliations": [
        "University of Debrecen, Faculty of Pharmacy Department of Pharmacology, Debrecen, Hungary"
      ],
      "name": "A Fésüs"
    }
  ],
  "title": "4CPS-046 Evaluation of antibiotic use in patients admitted to the intensive care unit (ICU) with pneumonia and sepsis: retrospective observational before-after study",
  "uid": "7e83b8aa-1b97-5d6c-82d1-1d09a99efdde"
}