EAHP represents over 30,000 hospital pharmacists across 37 member countries. EAHP represents and develops the hospital pharmacy profession within Europe in order to ensure the continuous improvement of care and outcomes for patients in the hospital setting. This is achieved through science, research, education, practice, as well as sharing best-practice and responsibility with other healthcare professional
The EAHP Board, elected for three-year terms, oversees the association’s activities. Comprising directors responsible for core functions, it meets regularly to implement strategic goals. Supported by EAHP staff, the Board controls finances, coordinates congress organization, and ensures compliance with statutes and codes of conduct.
The EAHP staff supports the Board in executing EAHP’s mission. The Staff assists in financial management, events organisations, policy activities and all EAHP projects. The EAHP staff works closely with EAHP’s members and ensures the effective communication all relevant stakeholders.
The first member countries were Belgium, Britain, Denmark, France, the Federal Republic, Germany, Italy and The Netherlands in 1972. EAHP has now 36 EAHP members and 2 Associate Members. EAHP is open to countries members of the Council of Europe and since 2022 to organisations representing the interests of hospital pharmacists from outside the Council of Europe (Associate Membership)
EAHP’s structure is also composed by different standing committes: EAHP Scientific Committee, EAHP Education Executive Committee and the EAHP CTF Steering Committee.
At EAHP, we are committed to transparency in our governance, ethical standards, and funding practices. This section provides open access to our foundational documents, including the EAHP Statutes, Code of Conduct, and Funding Sources. By sharing these resources, we aim to uphold accountability and foster trust with our members, partners, and the public.
Keep up with all EAHP’s events and webinars. Contact the team at info@eahp.eu should you have any questions about upcoming events or activities.
Here you can find all upcoming events organised by EAHP and by all its members and associate members. Do not hesitate to contact the events team at events@eahp.eu should you have any questions about the organisation of these events.
Hospital pharmacists conduct a critical role in the care of patients in hospitals. Learn more about what they do here and in all the pages under Hospital Pharmacy practice and Policy.
Self-Assessment
SILCC
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EAHP brings together experts from many areas of hospital pharmacy practice providing and highlighting good local sustainable practices as that can be up-scaled and shared with other countries. The EAHP Working Group on Sustainability has the aim of reducing the environmental burden of the hospital pharmacy services.
The European Association of Hospital Pharmacists (EAHP), and its 36 member country platforms are creating a Common Training Framework for the hospital pharmacy education in Europe. The goal of this project is to allow the free movement of hospital pharmacists within the European Union.
The European Association of Hospital Pharmacists (EAHP) and the European Society of Clinical Pharmacy (ESCP) have collaboratively developed the Oath to Society. The Oath to Society is all encompassing and acts as a contract for excellence in providing compassionate patient care, working as part of the healthcare team and advancing the pharmacy profession, and showcasing how clinical and hospital pharmacists work every day
A day created to highlight the importance and to celebrate the work done by hospital pharmacies. This day celebrates all hospital pharmacy teams.
The Early Career Network aims to empower early-career pharmacists by sharing opportunities, insights, and success stories from across 25 member countries.
Together, we’re building a stronger, more connected hospital pharmacy community: one story, one country, one pharmacist at a time.
Catch up with EAHP’s press releases
Find all EAHP relevant publication like the EAHP Surveys, annual reports and the history books.
The European Journal of Hospital Pharmacy (EJHP) is the only official journal of the European Association of Hospital Pharmacists (EAHP) and is committed to advancing the science, practice and profession of hospital pharmacy. As the premier communication platform for hospital pharmacists worldwide, EJHP is a major source for continuing education as well as updates on advances in the practice and standard of pharmaceutical care for patients.
When EAHP and Hospital pharmacists appear in the news.
EAHP publishes a monthly EU monitor with updates about the latest EAHP initiatives and information relevant for the hospital pharmacy profession.
The Sponsor Channel is designed to maximise visibility and engagement, allowing sponsors to connect with the hospital pharmacy community and partners in a dynamic and interactive environment. From product demonstrations to networking sessions, the Sponsor Channel offers a range of opportunities for sponsors to showcase their offerings and generate leads in the new EAHP Website.
Patient Safety and Quality Assurance
Sandra Oliver, Chief Clinical Information Officer, Pharmacy and Medicines.
Chris Green, Director of Pharmacy and Medicines Optimisation
We describe how our hospital experienced a cyber-attack which resulted in the electronic patient record and other systems being taken offline, including our electronic prescribing system.
We describe our response to the cyber-attack and the considerations necessary to replace an entire hospital’s electronic prescribing system with paper. We also describe the co-dependencies with other previously electronic departments and systems, and communications with partner organisations.
The conversion from electronic to paper prescribing was led by the pharmacy team. Initially, this was via a printed downtime solution from the electronic prescribing system, which then required transcription to a paper prescribing chart. This generated a number of logistic, practical and safety issues which were managed by the pharmacy team. We then describe how the hospital was converted back to electronic prescribing over the course of one day, and how the pharmacy team was pivotal to that.
We were able to successfully take our hospital off electronic prescribing and initiate a paper-based downtime solution that ran over several days, and then return the hospital to electronic prescribing. Recovery efforts involved pairing prescribers with pharmacists across wards, establishing a pharmacy command centre, coordinating medication administration on ePMA, and communicating service updates across the Trust. Third-party services were reinstated, and recovery was prioritised by acuity, with the least acute wards addressed first. During the downtime period, we actively encouraged the pharmacy team to log patient safety concerns, or ideas to improve the downtime process which were reviewed and acted on in real time and as part of the post-recovery review.
We have learned several valuable lessons from the downtime experience which we have taken forward as part of our revised business continuity plan. This includes a review of specialist prescribing situations for example insulin, how we contact and work with partner organisations, the robustness of our downtime printer setup, and training material for clinical staff who at the time of the cyber-attack, had never used a paper based prescribing system. This case study serves as a valuable resource for healthcare organisations seeking to strengthen their cybersecurity and business continuity strategies.
Education and Research
Dr Fernando Perez
Connor Thompson-Poole
Dr Konnie Basu
Recent changes in UK pharmacy education standards by the General Pharmaceutical Council (GPhC) have emphasised the need for pharmacists to graduate with the confidence and competence to undertake independent prescribing roles. This requires proficiency in physical assessment and diagnostic skills, traditionally outside the scope of undergraduate pharmacy education. To address this gap, the University of Brighton has integrated a structured simulation-based physical assessment training package into the MPharm curriculum, preparing future pharmacists for enhanced clinical responsibility and interprofessional practice.
A series of simulated physical assessment sessions was introduced across all years of the MPharm programme. The training focuses on developing students’ competence and confidence in performing fundamental physical assessment techniques, including cardiovascular, respiratory, gastrointestinal, and neurological examinations, as well as accurate recording and interpretation of vital signs through a spiralled curriculum over the course of four years.
The simulation package was designed collaboratively by clinical academic staff and prescribing pharmacists, supported by colleagues from medicine and nursing to ensure cross-disciplinary alignment. Each session was structured around case-based clinical scenarios, encouraging students to follow a patient’s journey through different healthcare settings.
Sessions were delivered in the university’s clinical simulation suites using simulated patients, high-fidelity manikins, and digital monitoring tools. Each workshop included a short demonstration, guided practice, peer feedback, and reflection activities. Students benefit from this approach as they can individually work through real clinical scenarios, which better prepares them for future independent clinical practice.
Student learning was assessed through Objective Structured Clinical Examinations (OSCEs) and reflective portfolios. Staff feedback and student evaluations were collected to guide ongoing improvement.
Over two academic years, over 400 pharmacy students have participated in the programme. Student feedback indicates a marked increase in self-reported confidence in patient examination, clinical communication, and integration of physical findings into clinical reasoning. Staff observed improved engagement and enhanced preparedness for prescribing training. The initiative has also fostered stronger collaboration across disciplines.
Future plans include developing interprofessional simulation days with medical and nursing students, and exploring digital tools for remote clinical assessment practice. The model demonstrates a scalable and sustainable approach to embedding clinical examination competence within undergraduate pharmacy education.
Clinical Pharmacy Services
Anais Carrillo Burdallo
Cristina Villanueva Bueno
Maria del Pilar Montero Antón
Isabel Regalado-Artamendi
Beatriz Torroba Sanz
Jose Luis Revuelta Herrero
Eva González-Haba Peña
Daniel Gomez Costas
Yeray Rioja Díez
Antonio Prieto Romero
María Martín Bartolomé
Xandra García Gonzalez
Ana Herranz Alonso
Maria Sanjurjo Saez
High-dose methotrexate (HD-MTX) carries substantial toxicity risk. Safety hinges on timely, appropriately dosed leucovorin rescue plus high-volume hydration and urinary alkalinisation. Pharmacokinetic monitoring with proactive follow-up enables early detection of delayed clearance and better-informed decisions.
A protocol for the administration and pharmacokinetic monitoring of HD-MTX was developed and implemented in a tertiary hospital in coordination with the Haematology Department.
Standardised procedures for administration were defined (hydration/alkalinisation strategies; rescue timing/dose; infusion start; sampling schedule). Adults with leukaemia/lymphoma received short (5µmol/L; long: 42h, >1µmol/L).
Pharmacist-led interventions were classified as: enhanced elimination (intravenous fluids/furosemide; bicarbonate/acetazolamide; cholestyramine), rescue optimisation (dose guided by the prediction, readjusted after the measured level, and withheld when appropriate), and monitoring (additional levels and duration).
Continuous accuracy was assessed with the individual percentage error (IPE)=[(predicted−observed)/observed]×100; we report MDIPE (median IPE; accuracy), MAIPE (median absolute IPE; precision), and the proportion within 1.5-fold. Classification against thresholds was summarised with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).
In 24 administrations (13 short, 11 long), pharmacist-led interventions were implemented in every cycle: enhanced elimination 88%, rescue optimisation 54%, monitoring 71%.
Continuous accuracy: MDIPE +35% (IQR 9–80), MAIPE 38% (IQR 11–80); 54% within 1.5-fold. Threshold performance (short/long): accuracy 69/91%; sensitivity 100/100%; specificity 67/86%; PPV 20/80%; NPV 100/100%.
Protocolised monitoring improved safety by standardising decisions and reducing errors. The predictive tool achieved 100% sensitivity and NPV, supporting early rule-out of delayed clearance; positive alerts should be interpreted cautiously given moderate overprediction and false positives near thresholds, with confirmation and close follow-up.
Next steps are full rollout, recalibration and threshold tuning in larger cohorts, and extension to Oncology and Paediatrics, tracking efficiency endpoints (time to <0.05-0.2 µmol/L, length of stay).
Selection, Procurement and Distribution
Calzavara E. (author); Battistutta C.; Zanella E.; Venturini F.
Imported medicines are often used during national shortages or when certain drugs are unavailable in Italy. These products frequently lack documentation in Italian or English, increasing the risk of prescribing errors. To address this gap and enhance patient safety, the system was introduced in early 2024, providing immediate access to translated information at the point of care. Moreover, this system helps split packs with many doses.
The Hospital Pharmacy of the University of Padua developed and implemented a system where imported medicines are labelled with a QR code linking to the Summary of Product Characteristics (SmPC) translated into Italian. Translations are generated using automatic tools and reviewed by pharmacists for accuracy. The QR code, placed directly on the packaging, allows healthcare professionals to access the translated SmPC instantly via mobile devices. Since 2024, 128 imports have been made, with labels created for 6 drugs: Catapresan tablets (Germany), Lysine Acetylsalicylate IV and Suxamethonium IV (Portugal), Rifampicin tablets and Neostigmine IV (India), flecainide IV (Japan).
Translations are stored on a secure internal cloud system. Each QR code, affixed by the Pharmacy to the medicine box, links directly to the corresponding SmPC translation. It was challenging to link translations to a QR code, but after several attempts, we succeeded using a specific cloud function. If there are any doubts about the translation’s accuracy, wards are warned to consult the original SmPC or contact the Pharmacy.
Requests from wards for SmPC translations have significantly decreased. This is particularly impactful when dealing with medicines labelled in non-Latin scripts (e.g., Chinese, Greek, Japanese), which can delay interpretation and increase the risk of medication errors, especially in urgent situations where rapid access to information is critical. The initiative has proven cost-effective, scalable, and beneficial to both safety and workflow. It offers a replicable model for other hospitals dealing with imported drugs.
A shared cloud folder is being created, containing both original and translated SmPCs, organized by internal code and drug name. This will allow staff to quickly retrieve documents using a simple search. A satisfaction survey will soon assess the system’s effectiveness from the wards’ perspective.
Patient Safety and Quality Assurance
Pinzon Garcia, Viviana Andrea
Fajardo Escolar, Angelica Paola
Since implementing the Opioid Stewardship Programme in 2018, we have improved the management of morphine and hydromorphone in our hospital. This has not only reduced medication waste, but also created a hospital culture that recognises the importance of standard single-dose in ensuring medication safety. Based on this, we extended the programme to include other controlled medicines, after identifying the need to limit the use of vials and ampoules of fentanyl, remifentanil and ketamine considering the available commercial presentations and the probability of using these products on multiple patients without maintaining their sterility.
We extended the coverage and monitoring of the unit-dose system to include other controlled medications apart from morphine and hydromorphone, through interdisciplinary collaboration between the Anaesthesia and Pharmacy Departments, with the aim of reducing waste and the risk of misuse at San Ignacio University Hospital, a high-level hospital in Bogotá, Colombia.
As part of the annual Pharmacy and Therapeutic Committee operative plan, the pharmacy and anaesthesia departments evaluated the risks in the medication order cycle of opioids and other controlled medications, defining strategies using an improvement cycle model. We assessed the feasibility of preparing unit doses of these medications, as well as the storage, preservation conditions and logistics of medication inventory. We deployed the strategy through staff training, mainly in operating rooms, intensive care and resuscitation, and established a follow-up of consumption and adherence, records of remnant disposal, cases of naloxone use and events reported to the pharmacovigilance programme.
The average proportion of standard single-dose prescriptions in 2025 was 74% for hydromorphone, 77% for morphine, 84% for fentanyl and 50% for remifentanil. Through our compounding center, we prepared 143,854 doses of these medications in 2024 and 78,421 from January to August 2025. The inventory write-off percentage due to expiration was 1.06% in 2024 and 0.38% in the first eight months of 2025. The percentage of hospitalised patients who received naloxone was 0.20 in the first semester of 2024 and 0.17 in the first semester of 2025.
Conducting interdisciplinary rounds in services to identify on-site adherence to implemented practices and supportting Human Talent, maintaining the improvement cycle process.
Patient Safety and Quality Assurance
Elisabetta Volpi, Hospital Pharmacy, Ospedale del Cuore, Fondazione Toscana Gabriele Monasterio;
Irene Benassi, Specialisation school in Hospital Pharmacy, University of Pisa;
Sara Tonazzini, Hospital Pharmacy, Ospedale del Cuore, Fondazione Toscana Gabriele Monasterio;
Giuseppa Lo Surdo, Hospital Pharmacy, Ospedale del Cuore, Fondazione Toscana Gabriele Monasterio;
Mario Cossu, Information systems and information technologies, Fondazione Toscana Gabriele Monasterio
Maurizio Mangione, Information systems and information technologies, Fondazione Toscana Gabriele Monasterio
Mattia Lorenzini, Nursing, Technical and Rehabilitation Service, Fondazione Toscana Gabriele Monasterio;
Stefania Baratta, Nursing, Technical and Rehabilitation Service, Fondazione Toscana Gabriele Monasterio;
Pierantonio Furfori, Anesthesia and Resuscitation Unit, Ospedale del Cuore, Fondazione Toscana Gabriele Monasterio;
Paolo Del Sarto, Anesthesia and Resuscitation Unit, Ospedale del Cuore, Fondazione Toscana Gabriele Monasterio;
Stefania Biagini, Hospital Pharmacy, Ospedale del Cuore, Fondazione Toscana Gabriele Monasterio.
Most preventable adverse events occur during medication use, especially with intravenous (IV) drugs requiring preparation before administration. Furthermore, for infusions, proper labelling is critical to reduce the risk of medication errors.
Our hospital has used an electronic therapeutic record (eSTU) for over 10 years. In 2020, a multidisciplinary team of anesthesiologists, pharmacists, nurses and health IT specialists developed a dedicated module to ensure traceability of drug prescribing and administration in the operating room, focusing on cardiac surgery. At the same time, infusion syringe labelling evolved from handwritten to computerized labels, improving safety and traceability. This study aimed to assess impact of a standardized electronic prescribing and labelling system.
All standardized IV prescriptions issued during cardiac surgeries between 2021 and June 2025 were included in the analysis. Prescriptions were categorized by administration mode (bolus or infusion) to assess healthcare professionals’ adherence to the standardized prescribing system. A qualitative evaluation of labels applied to infusions was also performed.
The standardized prescription system was used in 5.272 procedures (4.542 adults; 730 pediatric), averaging 1.009 adult and 162 pediatric surgeries per year. A total of 93.291 prescriptions were recorded (81.861 in adults, 18 per procedure; 11.430 in pediatric cases, 16 per procedure), with a progressive increase from 18.211 prescriptions in 2021 to 20.955 in 2024 (+15.1%). These results confirm the system’s usability and effectiveness of staff training. Qualitative analysis of labelling practices initially showed syringe labels were handwritten and included limited information (e.g., drug name, concentration). With the computerized system, printed labels now contain detailed data: drug name, identifying code, dose, diluent, concentration, preparation date and time.
Our data demonstrate, for the first time, that the adoption of a standardized prescription system in cardiac surgery is an effective strategy, offering a fast, safe and user-friendly approach. Furthermore, computer-generated labelling ensures complete traceability and reduces the risk of medication errors.
Growing adoption of standardized prescription in both adult and pediatric cardiac surgery confirms its feasibility in high-complexity settings. Extending this system to other surgical areas (e.g., Gynecology, Hemodynamics, Electrophysiology) may further enhance medication safety across the hospital.
Clinical Pharmacy Services
Sebastian Philip, Andreas Lundgaard
The screening aimed to ensure the rational use of antibiotics, contributing to the fight against antibiotic resistance and potentially shortening hospital stays by optimizing treatment.
A systematic screening of antibiotic treatments for patients was conducted as part of the daily tasks performed by clinical pharmacists at The Medical Acute Care Unit, Bispebjerg Hospital.
For each patient receiving antibiotic treatment in the emergency department, the chosen therapy was systematically reviewed against regional antibiotic guidelines, considering factors such as allergies, resistance profiles, renal function, clinical indication and overall condition of the patient. Recommendations of adjustment of treatment were discussed with the attending physician for potential changes in therapy, including changes to dosage, frequency, route of administration, alternative antibiotic drug, or discontinuation of treatment. All interventions were documented, including the details of the therapy, the recommendation, and whether the attending physician approved the suggested changes.
A large dataset has been collected, detailing the number of patients receiving antibiotic treatment, the number of interventions conducted, the specific antibiotic treatment each patient received, the type of intervention performed and its indication, and whether the intervention was approved or rejected by the responsible physician.
The project has laid the groundwork for understanding the clinical pharmacist’s role in enhancing rational antibiotic pharmacotherapy.
It is planned to analyze the collected data to determine the types of changes in therapy most commonly recommended by clinical pharmacists and to which degree the interventions were approved or denied by the attending physician.
This will provide insights into the pharmaceutical contributions to more rational antibiotic use, highlighting commonly observed ‘areas for improvement’ that could potentially be addressed through education.
Patient Safety and Quality Assurance
ANDREA RODRÍGUEZ ESQUÍROZ, AMAYA ECHEVERRÍA GORRITI, Mª CONCEPCIÓN CELAYA LECEA, MARTA MARÍN MARÍN, LOREA SANZ ÁLVAREZ, PATRICIA GARCÍA GONZÁLEZ, JAVIER GORRICHO MENDIVIL, JAVIER GARJÓN PARRA.
A prescription alert system was developed in our region for the management of drugs in patients with hepatic cirrhosis.
A preliminary study made in our region showed that around one in four prescribed medications in cirrhotic patients are contraindicated or overdosed. Besides, it is estimated that around 38% of cirrhotic patients suffer any adverse effect despite approximately 70% of them are preventable.
In addition, safety problems can emerge due to the lack of data regarding drugs management in patients with cirrhosis.
For these reasons, it was essential to develop a tool that helped clinicians during the prescription process and pharmacists while pharmaceutical validation and medication review.
A computer-generated prescription alert system was developed. This system provides security data and dosing recommendations according to Child-Pugh classification of each patient. Besides, the tool suggests safer alternatives when an unsafe drug is prescribed. These recommendations were extracted from the product information and three databases: UpToDate, RxCirrhosis and Geneesmiddelen bij.
According to last laboratory data available from the electronic medical records such as bilirubin, prothrombin time and albumin, this tool estimates the Child-Pugh score, that must be completed with ascites and encephalopathy grade.
At this time, this tool is only available for clinical pharmacists for validation, and it is expected to be implemented for physicians soon.
From May to September 2024, a total of 202 drugs were included, 59 (29.2%) were considered contraindicated in some degree of cirrhosis, so it was recommended not to use. Dose adjustment was proposed in 109 (54.0%) drugs, while in 13.9% the tool recommended a safer alternative drug.
In order to complement this issue, information and training sessions were given about safe management of drugs in cirrhotic patients.
We are working in order to include safety data about more drugs in this alert system.
We hope this tool can help professionals of other regions and countries.
Clinical Pharmacy Services
A. ALENTADO MATEU 1 , L. ALVAREZ ARROYO 1 , R. MARTINEZ GOZALBEZ 2 , O. PEREZ OLASO 3 , R. LIMÓN RAMIREZ 4, B. MONTAÑÉS PAULS 1 .
1 HOSPITAL UNIVERSITARIO LA PLANA, FARMACIA, VILA-REAL, ESPAÑA.
2 HOSPITAL UNIVERSITARIO LA PLANA, INFORMÁTICA, VILA-REAL, ESPAÑA.
3 HOSPITAL UNIVERSITARIO LA PLANA, MICROBIOLOGIA, VILA-REAL, ESPAÑA.
4 HOSPITAL UNIVERSITARIO LA PLANA, MEDICINA PREVENTIVA, VILA-REAL, ESPAÑA.
For years, Antimicrobial Stewardship Programs (ASP) teams have been working to improve the quality of antimicrobial prescription by optimizing treatments, controlling bacteremia and managing infections caused by resistant or difficult to treat microorganisms.
It is essential to have a software tool that allows real-time monitoring of both treatments and certain cultures.
The ASP team, in collaboration with the information technology unit designed, developed and implemented a computer application at our center to support the ASP team. This application screens inpatients, searching for any of the predefined parameter alerts based on the type of antibiotic prescribed, the microorganism causing the infection, positive blood cultures or patients who are difficult to manage.
This alert system is based on the integration of the various hospital clinical information systems. Admitted patients are selected after a medical prescription of certain predefined antibiotics (carbapenems, daptomycin, linezolid, piperacillin/tazobactam, ceftazidime/avibactam, etc); these data are obtained from the electronic prescription programme (Athos-Prisma®). Microbiological criteria (Gestlab@ programme) include multi-resistant microorganisms (Escherichia coli, Methicillin-resistant Staphylococcus aureus), positive blood cultures, Pseudomonas, etc. Based on clinical criteria, patients who are difficult to manage can be manually included in the computer programme, mainly by the internal medicine and intensive care unit departments. The antimicrobial and microbiological criteria are dynamic and can be modified as needed.
From June 1 st 2023 to February 1 st 2024, 300 different patients have underwent interventions. In the patient’s electronic medical record from the ASP application, 355 ASP recommendations were made for 236 patients. ASP interventions included recommended isolation measures (242), modifying or suspending antibiotic treatment (68), maintaining adequate antibiotic treatment (22), initiating antibiotic treatment (11) and requesting complementary tests (12), such as imaging, cultures or serology.
This application is a fundamental communication tool for ASP teams allowings different recommendations for optimizing antimicrobial treatment to be made in the application. It automatically generates a note in the patient’s clinical history, making it accessible to all healthcare professionals and allowings for easy extrapolation to other hospitals, enabling its implementation in daily clinical practice.
Clinical Pharmacy Services
Solís-Cuñado S. (1), Sánchez-Cerviño A.C. (2), Martínez-Núñez M.E. (1), Gómez-Bermejo M. (1), Martín-Zaragoza L. (1), Rubio-Ruiz L. (1), Onteniente-González A. (1), Molina-García T. (1)
1. Hospital Pharmacy Service, Getafe University Hospital, Getafe (Madrid), Spain.
2. Hospital Pharmacy Service, Puerta de Hierro University Hospital, Majadahonda (Madrid), Spain.
The implementation of multidisciplinary antimicrobial stewardship teams(AST) in hospitals optimizes antibiotic use in order to improve clinical results, reduce antibiotic toxicity and minimize the emergence and spread of multidrug resistant(MDR) bacteria.
The objective is to present targeted interventions for the improvement of the management of lower respiratory tract infections(LRTI) and to reflect the impact of these strategies through the presentation of antibiotic use results.
Two main interventions have been implemented in LRTI:
-Protocolize the management of community-acquired pneumonia(CAP) in order to prioritize beta-lactam plus macrolide(bLM) combination versus fluoroquinolones(FQ) monotherapy. The aim is to decrease FQ consumption due to their safety issues and the major role of this antibiotics in the emergence of MDR bacteria.
-Identify patients with severe LRTI and/or risk factors of multi-drug resistant(RFMDR) bacterial infections to encourage nasal swab screening(NSS) for meticillin-resistance Staphylococcus aureus(MRSA) to promote de-escalation of anti-MRSA antibiotics.
Study period: 2023 and first semester of 2024.
-CAP guideline: we studied the bLM vs FQ consumption expressed as the ratio between bLM DOT/FQ DOT (Days Of Therapy; DOT) in all hospitalized patients. Analysis was carried out on forth-month period.
-NSS: we reviewed the total number of NSS performed and the impact on duration of antiMRSA antibiotics therapy. Analysis by semesters.
After protocolization, the BLM´s DOT/FQ´s DOT ratio increased 39.4% from the beginning of 2023 until 2024: 0.66 vs 0.92.
Our AST reviewed 378 episodes of LRTI. At least one nasal screening was performed in 60.6% of episodes (n=229/378) of which 29.2% were positive (n=67/229). The mean duration of treatment with anti-MRSA antibiotics in the positive cases was 7.42 days, while in the 214 negative cases it was 6.4 days.
69% of the patients with LRTI that have been reviewed in our AST meets at least one RFMDR.
The frequent lack of diagnostic value of respiratory samples, coupled with the high percentage of RFMDR patients, results in long-lasting broad-spectrum empirical antibiotic treatments.
It is therefore proposed that a polymerase chain reaction(PCR) test be performed on candidate patients for the purpose of screening for MRSA, with a view to obtaining rapid results that will facilitate earlier antibiotic de-escalations.
