Impact of an Antimicrobial Stewardship Program (ASP) on the Optimal Selection of Antibiotic Prophylaxis in Cesarean Delivery in a Hospital Without Restrictions on the Use of Antibiotics: First ASP in Costa Rica

BACKGROUND: Antimicrobial Stewardship Programs (ASP) have the potential to improve patient outcomes, decrease bacterial resistance, increase patient safety, and decrease costs. In a private hospital without restrictions on the use of antibiotics, the improvement in antibiotic use depends mainly of prospective feedback and education. The purpose of this study was to characterize the impact of the ASP (PROA-HCB) on the appropriate selection of antibiotic prophylaxis in cesarean delivery and ceftriaxone and cefazolin utilization. METHODS: Retrospective analyses of six months before and six months after ASP intervention in the optimal selection of antibiotic prophylaxis (selection, dosage, duration) in cesarean delivery and consumption of ceftriaxone and cefazolin in the year of the intervention. RESULTS: Percentage of optimal selection of antibiotic prophylaxis in cesarean delivery was 0.5% (n = 553) in the pre-ASP period and 80.0% (n = 662) in the post-ASP period (76.5% absolut improvement, P < 0.001). Mean ceftriaxone utilization was 274.7 defined daily doses (DDD) per 1,000 patient days DDD for the pre-ASP period and 196.4 DDD per 1,000 patient days for the ASP period (28.5% decrease; P = 0.002). Mean cefazolin utilization was 6.4 DDD per 1,000 patient days for the pre-ASP period and 37.2 DDD per 1,000 patient days for the ASP period (581.3% increase; P = 0.002). CONCLUSION: ASP initiatives were associated with an observed improvement on the optimal selection of antibiotic prophylaxis in cesarean delivery, reduction in ceftriaxone utilization and increase cefazolin utilization. DISCLOSURES: All authors: No reported disclosures.