2040. Evaluation of Inpatient Antimicrobial Prescribing Practices in Cochabamba, Bolivia

BACKGROUND: Many developed nations have made antimicrobial stewardship a priority, creating benchmarks and national standards. Little has been published on the antimicrobial use and stewardship efforts in resource-limited countries due to difficulties collecting data. Viedma Hospital (VH) is a 200-bed hospital in Cochabamba, Bolivia, with no formulized antimicrobial stewardship (AMS) program. To better understand the antibiotic (ABX) use at VH, a point prevalence study was conducted in partnership with UMass Medical School. Point prevalence studies comprehensively review patients prescribed antibiotics using standard criteria in the hospital at a specific point-in-time. Using prevalence studies, areas of opportunity can be identified to focus on limited AMS efforts. METHODS: This was an observational study completed through a 2-day chart review. Patients were included if they were greater than 16 y/o, admitted to the general medicine, surgical or intensive care floors at VH and receiving systemic ABXs at the time of review. Data were collected on location, clinical service, day of hospitalization, sex, age, fever, white blood cell count, immunocompromised status, ABXs prescribed including dose, duration and frequency, the indication for each ABX and microbiology results. RESULTS: 161 patients were admitted to the hospital during the point prevalence study, of which 85 (52.7%) were prescribed ABXs. Most ABXs were empiric (83%) and frequent indications included intra-abdominal infections (21.3%) and cellulitis (14.5%). Based upon evaluation utilizing standard criteria, 60% of ABXs were considered unnecessary, inappropriate or suboptimal. Common reasons for unnecessary ABXs was the excessive length of antimicrobial therapy (14%), inappropriate dosing of ABXs (8.5%) and no documented infection (51%). CONCLUSION: There is limited data discussing ABX utilization in Bolivia, despite continued use and growing resistance. The point prevalence review identified areas of inappropriate use. This evidence will be utilized to focus AMS efforts on the creation of empiric ABX selection, dose and duration recommendations for common indications. DISCLOSURES: All authors: No reported disclosures.