Trends of Antimicrobial Consumption in Hospital: Tackling the Hidden Part of the Iceberg with an Electronic Personalised Prescription Software for Antimicrobial Stewardship.

BACKGROUND: The monitoring of antibiotic prescriptions is of fundamental importance in the hospital setting. Inappropriate prescriptions could cause an unjustified exposure of patients to the risk of ADR (adverse drug reactions) and increase the risk of spreading the ecological resistance of hospital microorganisms. The use of IT media is essential in antimicrobial stewardship programs. OBJECTIVE: The purpose of this work was to evaluate the variation in the exposure index to antibiotics following the adoption of electronic pharmacist-controlled prescriptions in 2015. METHODS: Electronic Personalised Prescription Software (EPPS) was introduced in our University Hospital in 2015. The exposure index to antibiotics was expressed per WHO methodology in DDD (defined daily dose)/100 patient days (DPD). The changes in DPDs over the 2015-2020 period were calculated as percentages and through linear regressions. The analysis was performed using SPSS® (IBM). RESULTS: Following the introduction of EPPS, there was a progressive decline in DPDs during the 2015-2020 period from 98.9 to 65.1 (R2 = 0.687, p = 0.041). This could mainly be linked to the decreased use of ATC class J01CR - penicillin association, including beta-lactamase inhibitors (DPD 2015 39.9; DPD 2020 11.5; variation -71.1%). Expenditure progressively decreased from € 427,000 in 2015 to € 269,000 in 2020. CONCLUSION: The use of EPPS was shown to be useful for pharmacists in implementing proper antibiotic dispensing practices; the avoidance of inappropriate prescriptions leads to a better monitoring of DPDs and the related expenditure which is the main goal of antibiotic stewardship programs.