Post-Prescription Review and Feedback: The Hospital Queen Elizabeth II Experience

Introduction: Hospital Queen Elizabeth II (HQEII) implemented post-prescription review and feedback (PPRF) as part of our antimicrobial stewardship strategy.   Objectives: This study evaluates PPRF conducted twice weekly in HQEII and compares its impact on antibiotic consumption.     Methods: This study was a retrospective cross-sectional study conducted from July to December 2019 from data collected during PPRF rounds. Antimicrobial consumption was compared with previous year using the defined daily dosing measures.     Results: A total of 847 PPRF reviews involving 538 patients receiving restricted antibiotics. Amongst these patients, 61.0% of them were men with a median age of 57 years old (IQR 41 - 68). The wards most visited during PPRF were the medical ward (n=354, 41.7%), followed by the intensive care unit (n=, 13.6%) and orthopedic ward (n=, 13.2%). It took an average of 2.5±2.3 days for the AMS team to conduct a review after an antibiotic was started. The antibiotic most reviewed was 3rd generation cephalosporins (n=273, 32.2%). The commonest diagnoses that prompted review was a respiratory tract infection (n=243, 28.7%). Antibiotics were de-escalated in half of the reviews (n=425, 50.1%).     The impact of the PPRF review on antibiotic consumption was observed in certain antibiotics. In particular, PPRF intervention significantly reduced consumption of antibiotics such as cefuroxime by 42% (62.0 vs 20.1, p<0.001), ceftriaxone by 41.3% (67.4 vs 26.1, p<0.001), and piperacillin-tazobactam by 12.3% (40.6 vs 28.2, p<0.017).     Conclusion: Intensive PPRF successfully reduces consumption of certain antibiotics. More studies are warranted to further analyze PPRF impact on clinical, microbiological, and economic outcomes. [Disclaimer: Abstract text might vary slightly from what is displayed in the e-poster]