2041. Impact of an Infectious Disease Specialist-led Post-Prescription Carbapenem Intervention in a Large Japanese Tertiary Hospital: A Before–After Cohort Study

BACKGROUND: There are fewer board-certified infectious disease (ID) specialists in Japan (n = 1494) than in the United States (n = 8535); therefore, we have insufficient protected time for antimicrobial stewardship activities, and thus, there is a need for an innovative solution. METHODS: This study compared carbapenem consumption between a 24-month baseline period and a 12-month intervention period at the Iizuka Hospital with 1048 inpatient beds in Japan. During the intervention period, a board-certified ID specialist provided daily feedback to prescribers against prolonged carbapenem use (≥14 days) through conversations and medical records. Additionally, we reported through e-mail the weekly point prevalence surveillance data of the long-term carbapenem users for 7–13 and ≥14 days, which were aggregated by each department. RESULTS: We provided a total of 106 feedbacks regarding carbapenem use for ≥14 days during the intervention period. After the initiation of intervention, the trend of monthly carbapenem consumption changed (coefficient: −0.62; 95% CI: −1.15 to −0.087, P = 0.024), and its overall consumption has decreased (coefficient: −0.098; 95% CI: −0.16 to −0.039, P = 0.002, Figure 1) without a change in the in-hospital mortality (P = 0.53) as revealed by segmented regression analysis. Interestingly, the number of monthly carbapenem users, but not the duration of carbapenem use, significantly decreased (coefficient: −3.02; 95% CI: −4.63 to −1.42, P = 0.001, Figure 2). An annual estimated saving after the intervention was $82,266 with a cost reduction of 22%. CONCLUSION: Our ID specialist-led daily intervention in carbapenem prescription and weekly feedback for long-term carbapenem use were effective in reducing this antibiotic’s consumption and consequently the number of carbapenem users. These feedbacks may be useful in changing the behavior of prescribers and promoting appropriate antimicrobial use even in resource-poor settings. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.