Category: Antimicrobial Stewardship: Outcomes Assessment (clinical and economic)

Poster Session: Antimicrobial Stewardship: Outcomes Assessment (clinical and economic)

81 - Physicians’ Knowledge, Attitude, and Practice regarding Prolonged Antimicrobial Use

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Presenting Author(s)

Da Young Kim

Dr
Chosun university Hospital
Gwangju, Cholla-namdo, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

Dk

Dahye kim

Pharmacist
Seoul National University Bundang Hospital
Seoungnam-si, Kyonggi-do, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
EH

Eunjeong Heo

pharmacist
Seoul National University Bundang Hospital
Seoungnam-si, Kyonggi-do, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
hK

hyung-Sook Kim

Pharmacist
Seoul National University Bundang Hospital
Seongnam, Kyonggi-do, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JP

Ji Young Park

Assistant Professor
Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Hl

Hyunju lee

Dr
Seoul National University Bundang Hospital
Seoungnam-si, Kyonggi-do, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Jun-won Seo

Prof
Chosun University Hospital
Gwangju, Kwangju-jikhalsi, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Jongtak Jung

Assistant Professor
Soonchunhyang University Seoul Hospital
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SM

Song Mi Moon

Associate Professor, Division of Infectious Diseases
Seoul National University College of Medicine
Seoungnam-si, Kyonggi-do, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
KS

Kyoung-Ho Song

Dr
Seoul National University Bundang Hospital
Seoungnam-si, Kyonggi-do, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
EK

Eu Suk Kim

Dr
Seoul National University Bundang Hospital
Bundang-gu, Kyonggi-do, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
HK

Hong Bin Kim

Dr
Seoul National University Bundang Hospital
Seoungnam-si, Kyonggi-do, Republic of Korea
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: To reduce unnecessary long-term antibiotic therapies, pharmacist-led intervention followed by the involvement of infectious diseases (ID) specialist was implemented. In addition, a survey for the prescribers was conducted to find the gaps for improvement.

Methods: The “less is better” intervention was implemented between August 1, 2018 and February 28, 2019, which was focused on those to whom antibiotics had been administered for over 15 days. However, the following patients were excluded: patients having hematologic diseases, patients in the neonatal intensive care units, and patients who were recommended to maintain antibiotics by ID specialist. Treatment duration according to the indications was compared between pre-intervention period (Aug to Sep 2017) and post-intervention period. A questionnaire based on clinical vignettes was distributed among 140 prescribers.

Results: Among 500 prescriptions assessed as a prolonged treatment, 475 (95%) were stopped after intervention. Over the pre- and post-intervention period, pneumonia was the most common indication of prolonged antibiotic use (43.8 versus 43.0%). The treatment durations decreased from 21.0 (interquartile range [IQR], 27.3-18.0) days pre-intervention to 16.0 (IQR, 20.0-15.0) days post-intervention (p=0.000).
The survey response rate was 76.4% (107/140). Regarding community-acquired pneumonia, there was a significant difference between knowledge and practice, showing that 53% were aware of the standard duration, but 72% actually prescribed for a longer duration. There was a similar trend for the treatment of urinary tract infection (30% versus 83%, p=0.024). The reasons why the physicians prescribed antibiotics of a prolonged duration in spite of adequate knowledge were not only the lack of symptom alleviation in patients but also organizational factors.

Conclusion: The duration of long-term antibiotic treatment was shortened by active participation of pharmacist as well as ID specialists. However, gaps between the knowledge and practice on the duration of antibiotic treatment were also found. Therefore, it is necessary to implement appropriate feedback and education based on clinical scenario in order to improve the physicians’ antibiotic prescription.