abstract book

24

March 2017 Volume 24 Supplement 1

S1 Volume 24 Supplement 1 Pages AX–AXX EUROPEAN JOURNAL OF HOSPITAL PHARMACY

ABSTRACT BOOK 22nd EAHP Congress 22–24 March 2017 Cannes, France

March 2017

CALL FOR ABSTRACTS - 2018 GOTHENBURG 23rd Congress of the EAHP, 21st - 23rd March 2018, Gothenburg, Sweden

Abstract submission opens 1st August, 2017! Original contributions from all fields of hospital pharmacy are encouraged and welcomed for poster presentation. Deadline for submission: 15th October 2017 During the review process, the award nominees will be selected and the presenting author of the nominated abstracts will be invited to give an oral presentation after which the final judging will take place. Please be sure to provide an email address which will not be blocked by spam servers so that EAHP may notify you for modifications and nominations. (Abstracts may be submitted through the EAHP web site’s online submission page.) IMPORTANT NOTE: The online submission form does not recognise some symbols from certain keyboards. Therefore, please proof your abstract after it has been entered into the system and before your final submission. Please visit the EAHP web site at http://www.eahp.eu/congresses/abstract to view the guidelines and to submit abstracts for the Gothenburg congress 2018. Abstracts must be entered into the system by section according to the guidelines. There will be 5 sections: Background - Purpose - Material and methods - Results - Conclusion

Contents

Volume 24 Supplement 1 | EJHP March 2017

Abstracts from the EAHP 2017 Congress A1 A109 A113 A158 A173

Clinical pharmacy Drug distribution Drug information and pharmacotherapy General management International posters

A179 A193 A202 A227

Other hospital pharmacy topics Pharmacokinetics and pharmacodynamics Production and preparation Patient safety and risk management

POSTER AWARD NOMINEES Presentations on Wednesday, 22 March, 14:00 – 15:00, Auditorium I Time

Poster number Poster nominee oral presentations

Author

14:00

PP-001

Hypromellose prolongs the dissolution of ketamine out of gelatine capsules

Länger, Ursula

14:10

PP-003

Stability study of bortezomib (velcade) with limit test for all degradation products

Nissen, Klaus Bertram

14:20

PP-014

Stability study of 10 mg/ml paediatric cyclosporine solution in olive oil

Mortier, Charles-Patrick

14:30

PP-029

Stability of frozen 1% voriconazole eye drops in glass and in innovative containers

Roche, Marine

14:40

PS-029

Feasibility of utilisation and patient satisfaction with a nationwide standardised electronic medication plan

Ulmer, Inga

14:50

PS-038

Developing a method for identifying a university hospital’s high alert medications

Tyynismaa, Lotta

Presentations on Thursday, 23 March, 09:00 – 10:00, Auditorium I Time

Poster number Poster nominee oral presentations

Author

09:00

CP-086

CD69 A>G (rs11052877) genetic polymorphism on the response to tocilizumab in rheumatoid arthritis patients

Díaz-Villamarín, Xando

09:10

CP-109

Evaluation of clinical, economic and organisational impacts of pharmacists’ interventions on immunosuppressive therapy management among lung transplant outpatients

Duwez, Marion

09:20

CP-116

Evaluation of the clinical significance and value of a clinical pharmacy service at a teaching hospital

Mueller, Dora

09:30

DI-052

Developing an interactive tool to educate patients on good management of drugs

Gschwind, Liliane

09:40

PKP-003

Influence of cytarabine metabolic pathway polymorphisms in effectiveness of acute myeloid leukaemia induction treatment

Megías-Vericat, Juan Eduardo

09:50

PKP-009

Relation between clinical remission and trough infliximab levels in children with inflammatory bowel disease

Cordelle, Claire

A invites ou to attend the ne g nte active ession

Anticoagulants - show me the evidence supported by an educational grant from Bayer

Wednesday, 22 March 2017 - 2:00pm to 3:30pm Thursday, 23 March 2017 - 9:00am to 10:30am Auditorium K

FACILITATOR

K ORNELIA C HRAPKOVA SOTIRIS ANTONIOU MEDICINES OPTIMISATION – IMPROVING ANTICOAGULATION GLOBALLY – INTRODUCTION CRAIG COLEMAN

PRESENTERS

THE IMPORTANCE OF ADHERENCE TO NON-VKA ORAL ANTICOAGULANTS IN NONVALVULAR ATRIAL FIBRILLATION

FILIPA COSTA OPTIMISING ADHERENCE IN ATRIAL FIBRILLATION HELEN WILLIAMS ADDRESSING UNMET NEEDS IN MANAGING AF ACROSS THE GLOBE

ACPE UAN: 0475-0000-17-005-L04-P. An application based activity.

The European Association of Hospital Pharmacists (EAHP) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education

EAHP

invitEs you

to AttEnd tHE

synErgy

2017

sAtEllitE EvEnt

10 YEARS OF BIOSIMILARS WHAT HAVE WE LEARNED ? supported by an educational grant from amgen

Wednesday, 22 March 2017 - 11:30am to 1:00pm Théâtre Claude Debussy

FACILITATOR

TORSTEN HOPPE-TICHY

PRESENTERS

PAUL DECLERCK The European Biosimilar Quality Experience IRENE KRÄMER Naming, tracing, switching and other safety issues after 10 years learning PAUL CORNES 10 years of biosimilars - who benefits? ACPE UAN: 0475-0000-17-004-L04-P. A knowledge based activity.

The European Association of Hospital Pharmacists (EAHP) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education

Abstracts

Clinical pharmacy CP-001

CP-002

WITHDRAWN

WITHDRAWN

Eur J Hosp Pharm 2017;24(Suppl 1):A1–A288

A1

Abstracts CP-003

CP-004

WITHDRAWN

A REVIEW OF URINARY TRACT INFECTION MANAGEMENT FOR PATIENTS ADMITTED TO THE EMERGENCY DEPARTMENT: ASSESSMENT OF ADHERENCE TO GUIDELINES AND IDENTIFICATION OF HOSPITALISATION CRITERIA

1

A Ramdani*, 2S Rebaudet, 3N Beni-chougrane, 4G Penaranda, 1E Coquet. 1Hôpital Européen, Pharmacy Department, Marseille, France; 2Hôpital Européen, Infectious Diseases Department, Marseille, France; 3Hôpital Européen, Sanitary Department, Marseille, France; 4 Alphabio, Biostatistics Department, Marseille, France 10.1136/ejhpharm-2017-000640.4

Background Community acquired urinary tract infection (UTI) is one of the most common indications for antibiotic prescription. Previous studies on adherence to guidelines on antibiotic use reported a prevalence of inappropriate prescriptions varying from 20% to 50%, in both community and hospital settings. The misuse of antibiotics not only has an important economic impact but can also lead to therapeutic impasses. Purpose This study aimed to establish the current management of UTIs in patients admitted to the emergency department (ED) of our hospital. Material and methods In this retrospective observational study conducted between January 2015 and May 2016, consecutive patients admitted to the ED for a suspected UTI were assessed, including patients hospitalised (n=50) or discharged (n=50) after their ED admission. Assessment of adherence to guidelines for antibiotic prescription was conducted using the guidelines of the French Speaking Society of Infectious Disease (SPILF). Results In the hospitalised group, 22 (44%) antibiotic prescriptions initiated at the ED did not comply with national guidelines. The two main causes for inappropriate prescriptions were the use of two antibiotics in patients with no severity criteria (15.68%) and/or the use of a non-recommended drug (6.27%). In this group, 17 (35%) antibiotic prescriptions ordered by the urologist on patient discharge did not comply with national guidelines. The two main causes of inappropriate prescriptions were the use of a non-recommended drug (9.53%) and an inadequate duration of treatment (9.53%). In the discharged group, 29 (60%) of the antibiotic prescriptions ordered at the ED did not comply with national guidelines. The two main causes of inappropriate prescriptions were an inadequate duration of treatment (23.79%) and the use of a non-recommended drug (19.66%). We also identified discrepancies between reasons for hospitalisation in our cohort compared with the criteria for hospitalisation mentioned in the national guidelines. Conclusion This study has identified areas for improvement in the management of UTIs in our hospital. Our suggestions for optimisation include educational materials and a decision tree displayed in the ED, and specific therapeutic protocols in our computerised prescription system. REFERENCES AND/OR ACKNOWLEDGEMENTS SPILF Guidelines 2015: http://www.infectiologie.com/fr/recommandations.html

No conflict of interest

A2


Abstracts CP-005

WITHDRAWN

CP-007

MEDICATION ERRORS IN VOLUNTARY REPORTED INCIDENTS AT A UNIVERSITY HOSPITAL

1

K Abu Hamour*, 2M Abdel Jalil. 1Jordan University Hospital, Amman, Jordan; 2University of Jordan, Biopharmaceutics and Clinical Pharmacy, Amman, Jordan 10.1136/ejhpharm-2017-000640.7

CP-006

WITHDRAWN


Background A significant yet preventable cause of inpatient and outpatient morbidity and mortality is medication errors. Appropriate error reporting systems are the cornerstone of any plan designed to enhance patient safety.1 Purpose The aim of the study was to assess the prevalence, origin, type and severity of reported medication incidents at a university hospital, utilising a voluntary non-punitive reporting system. Material and methods The present study had a retrospective design. All voluntary non-punitive incident reports that occurred between January 2014 and March 2015 at the hospital were retrieved from the quality department. Detailed content analysis was conducted to obtain all relevant information. Data were coded anonymously and analysed using SPSS version 20. Results There was an increase in reporting of medication errors over time, and almost all of the reports were from nurses. A total of 58 medication error reports, involving 86 medications, were related to errors in the medication management process, from prescribing and dispensing to administration of medications. Two-thirds of the reports originated from the internal medicine department and the neonatal intensive care unit. The most common drug classes associated with these reports were anti-infectives, cardiovascular and chemotherapy agents. The majority of errors occurred during the administration phase where missed doses and wrong time accounted for more than 52% of the reported incidents. Approximately 98.8% of reported incidents did not cause major harm to patients. Conclusion A low number of medication errors were reported in multiple hospital departments that increased over time, utilising a non-punitive system of reporting, suggesting an initial success of the system. Additional research is required to A3

Abstracts identify possible improvements to optimise and encourage reporting in addition to enhancing the response to each report. REFERENCES AND/OR ACKNOWLEDGEMENTS 1. Cohen MR. Why 2000;320:728–9.

error reporting

systems should be voluntary.

BMJ

Conflict of interest Corporate sponsored research or other substantive relationships: Dr Khawla Abu Hamour is the head of the pharmaceutical unit at the hospital.

therapy. A large decrease in the use of protease inhibitors in favour of integrase inhibitor family agents was observed, probably due to their better interaction pattern and metabolic profile. REFERENCES AND/OR ACKNOWLEDGEMENTS We thank Torrecardena´s hospital pharmacists for their support.


CP-009 CP-008

WITHDRAWN

COMPARISON OF PRESCRIPTION PROFILE OF ANTIRETROVIRAL DRUGS BETWEEN 2014 AND 2016 IN A TERTIARY CARE HOSPITAL

E Molina*, P Nieto, B Franco, S Cañizares, B Tauste, F Sierra. Andalusian Health System, Pharmacy, Almeria, Spain 10.1136/ejhpharm-2017-000640.8

Background Antiretroviral therapy for the treatment of human immunodeficiency virus type 1 infection has improved steadily since the advent of combination therapy. Purpose To compare the prescription patterns of antiretroviral therapy between 2014 and 2016. Material and methods Antiretroviral therapies used in 2014 were compared with those used in 2016 in patients affiliated with a tertiary care hospital in the Spanish Health System. Data were collected from the medication consumption files of the institution. Results 604 patients were treated in 2014 using 71 different combinations compared with 618 patients treated with 76 combinations in 2016. The percentage of men was 73% in both years. Total expenditure was ¼C 4 358 576 in 2014 and ¼ C 4 414 864 in 2016, with an average cost per patient of ¼ C 7216 and ¼C 7144, respectively. The 10 most common combinations of 2014 were used to treat 73.51% of patients, accounting for 69.31% of the total spending on antiretrovirals whereas the top 10 combinations of 2016 accounted for 78.64% of patients and 74.51% of the total spending. Some of these combinations were in the top 10 in 2014 but not in 2016. Similarly, some new combinations reached the top 10 in 2016. Taken together, 14 combinations were analysed in order. The change in number and per cent of patients with these combinations between 2014 and 2016 were as follows: emtricitabine/tenofovir/efavirenz (155 (25.66%), 91 (14.72%)), emtricitabine/tenofovir/rilpivirine (64 (10.60%), 117 (18.93%)), emtricitabine/tenofovir/lopinavir/ritonavir (52 (8.61%), 6 (0.97%)), emtricitabine/tenofovir/atazanavir/ritonavir (48 (7.95%), 16 (2.59%)), emtricitabine/tenofovir/darunavir/ritonavir (28 (4.64%), 15 (2.43%)), emtricitabine/tenofovir/nevirapine (25 (4.41%), 17 (2.75%)), emtricitabine/tenofovir/ raltegravir (22 (3.64%), 27 (4.37%)), darunavir/ritonavir (18 (2.98%), 10 (1.62%)), lopinavir/ritonavir (16 (2.65%), 6 (1.29%)), abacavir/lamivudine/nevirapine (16 (2.65%), 8 (1.29%)), emtricitabine/tenofovir/elvitegravir/cobicistat (0 (0.00%), 95 (15.37%)), abacavir/lamivudine/dolutegravir (0 (0.00%), 84 (13.59%)), dolugravir/rilpivirine (0 (0.00%), 14 (2.27%)) and emtricitabine/tenofovir/dolutegravir (0 (0.00%), 10 (1.62%)). Conclusion Changes made from 2014 to 2016 have permitted a slight decrease in cost per patient. Emtricitabine/tenofovir based therapies continue to be the backbone of antiretroviral A4


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ood mo ning ha macists ase studies on antimic o ial esistance hu sda a ch to Théâtre Claude Debussy HOSPITAL HOSPITALPHARMACISTS PHARMACISTSARE AREAN ANIMPORTANT IMPORTANTPART PARTOF OFTHE THEMULTIDISCIPLINARY MULTIDISCIPLINARYTEAM TEAM IMPLEMENTING IMPLEMENTING“ANTIMICROBIAL “ANTIMICROBIALSTEWARDSHIP STEWARDSHIPPROGRAMMES” PROGRAMMES”ININHOSPITALS. HOSPITALS.ININTHIS THISSEMINAR SEMINARSIX SIX HOSPITAL HOSPITALPHARMACISTS PHARMACISTSWILL WILLPRESENT PRESENTA ACLINICAL CLINICALCASE CASEFOCUSING FOCUSINGON ONAN ANINFECTIOUS INFECTIOUSDISEASE. DISEASE.

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ANTONELLA TONNA (ROBERT (ROBERT GORDON GORDON UNIVERSITY) UNIVERSITY) INESE SVIESTINA (UNIVERSITY (UNIVERSITY CHILDREN’S CHILDREN’S HOSPITAL) HOSPITAL) MARTIN HUG (MEDICAL (MEDICAL CENTER CENTER – UNIVERSITY – UNIVERSITY OFOF FREIBURG) FREIBURG) CASE 1

FRANCES KERR (MONKLANDS HOSPITAL, NHS LANARKSHIRE)

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Confidence from Evidence and Real World Experience Evidence from clinical and real world studies in NVAF1–3 and PE/DVT4,5 makes Xarelto® the world’s most prescribed NOAC,6 with over 26 million patients treated across all 7 indications worldwidea,7

NVAF, non-valvular atrial fibrillation; PE, pulmonary embolism; DVT, deep vein thrombosis; NOAC, non-vitamin K antagonist oral anticoagulant. a Calculation based on QuintilesIMS Health MIDAS Database: Monthly Sales October 2016. Indications may vary by country.

Xarelto 2.5 mg film-coated tablets (Refer to full SmPC before prescribing.) ▼ This medicinal product is subject to additional monitoring. Composition: Active ingredient: 2.5 mg rivaroxaban. Excipients: Microcrystalline cellulose, croscarmellose sodium, lactose monohydrate, hypromellose, sodium laurilsulfate, magnesium stearate, macrogol 3350, titanium dioxide (E171), iron oxide yellow (E172). Indication: Prevention of atherothrombotic events in adult patients after an acute coronary syndrome (ACS) with elevated cardiac biomarkers, co-administered with acetylsalicylic acid (ASA) alone or with ASA plus clopidogrel or ticlopidine. Contraindications: Hypersensitivity to the active substance or any of the excipients; active clinically significant bleeding; lesion or condition considered a significant risk for major bleeding; concomitant treatment with any other anticoagulants except under specific circumstances of switching anticoagulant therapy or when unfractionated heparin is given at doses necessary to maintain an open central venous or arterial catheter; concomitant treatment of ACS with antiplatelet therapy in patients with a prior stroke or a transient ischaemic attack (TIA); hepatic disease associated with coagulopathy and clinically relevant bleeding risk including cirrhotic patients with Child Pugh B and C; pregnancy and breast feeding. Warnings and Precautions: Clinical surveillance in line with anticoagulation practice is recommended throughout treatment. Xarelto should be discontinued if severe haemorrhage occurs. Increasing age may increase haemorrhagic risk. Not recommended: in patients with severe renal impairment (creatinine clearance 75 years of age or with low body weight; when neuraxial anaesthesia or spinal/epidural puncture is employed. Patients on treatment with Xarelto and ASA or Xarelto and ASA plus clopidogrel/ticlopidine should only receive concomitant treatment with NSAIDs if the benefit outweighs the bleeding risk. In patients at risk of ulcerative gastrointestinal disease prophylactic treatment may be considered. Although treatment with rivaroxaban does not require routine monitoring of exposure, rivaroxaban levels measured with a calibrated quantitative anti-Factor Xa assay may be useful in exceptional situations. Xarelto contains lactose. Undesirable Effects: Common: anaemia, dizziness, headache, eye haemorrhage, hypotension, haematoma, epistaxis, haemoptysis, gingival bleeding, gastrointestinal tract haemorrhage, gastrointestinal and abdominal pains, dyspepsia, nausea, constipation, diarrhoea, vomiting, pruritus, rash, ecchymosis, cutaneous and subcutaneous haemorrhage, pain in extremity, urogenital tract haemorrhage, renal impairment, fever, percipheral oedema, decreased general strength and energy, increase in transaminases, post-procedural haemorrhage, contusion, wound secretion. Uncommon: thrombocythemia, allergic reaction, © Bayer Pharma AG January 2017

G.MKT.GM.XA.01.2017.1258

dermatitis allergic, cerebral and intracranial haemorrhage, syncope, tachycardia, dry mouth, hepatic function abnormal, urticaria, haemarthrosis, feeling unwell, increases in: bilirubin, blood alkaline phosphatase, LDH, lipase, amylase, GGT. Rare: jaundice, muscle haemorrhage, localised oedema, bilirubin conjugated increased, vascular pseudoaneurysm (uncommon in prevention therapy in ACS following percutaneous intervention). Frequency not known: compartment syndrome or (acute) renal failure secondary to a bleeding. Post-marketing observations (frequency not assessable): angioedema and allergic oedema, cholestasis and hepatitis (incl. hepatocellular injury), thrombocytopenia. Classification for supply: Medicinal product subject to medical prescription. Marketing Authorisation Holder: Bayer Pharma AG, D-13342 Berlin, Germany Further information available from: [email protected] Version: EU/4 Xarelto 10 mg / 15 mg / 20 mg film-coated tablets (Refer to full SmPC before prescribing.) ▼ This medicinal product is subject to additional monitoring. Composition: Active ingredient: 10 mg / 15 mg / 20 mg rivaroxaban. Excipients: Microcrystalline cellulose, croscarmellose sodium, lactose monohydrate, hypromellose, sodium laurilsulfate, magnesium stearate, macrogol 3350, titanium dioxide (E171), iron oxide red (E172). Indications: 10 mg: Prevention of venous thromboembolism (VTE) in adult patients undergoing elective hip or knee replacement surgery. 15 mg / 20 mg: Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation with one or more risk factors, such as congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, prior stroke or transient ischaemic attack. Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrent DVT and PE in adults. Special populations: Patients undergoing cardioversion: Xarelto can be initiated or continued in patients who may require cardioversion. Contraindications: Hypersensitivity to the active substance or any of the excipients; active clinically significant bleeding; lesion or condition if considered a significant risk for major bleeding; concomitant treatment with any other anticoagulants except under specific circumstances of switching anticoagulant therapy or when unfractionated heparin is given at doses necessary to maintain an open central venous or arterial catheter; hepatic disease associated with coagulopathy and clinically relevant bleeding risk including cirrhotic patients with Child Pugh B and C; pregnancy and breast feeding. Warnings and Precautions: Clinical surveillance in line with anticoagulation practice is recommended throughout treatment. Xarelto should be discontinued if severe haemorrhage occurs. Increasing age may increase haemorrhagic risk. Not recommended: in patients with severe renal impairment (creatinine clearance 14 kPa. Data were collected from medical records, which also stored sociodemographic characteristics, HCV genotype, baseline viral load, coinfection with human immunodeficiency virus (HIV), pretreatment, HCV treatment, hepatic fibrosis and transaminases, bilirubin and platelet count before and after treatment. Results We obtained data from 22 patients (age 51.2±16.8 years, 19 (86.3%) men), genotype 3=2 (9.1%), HCV-HIV coinfected patients=51.9%, stage F3 8 (36%) and stage 4 12 (55%) patients. After treatment, in 14 (63.6%) patients liver fibrosis was partially reversed (median kPa pretreatment 17.1 vs 13.8 post-treatment); 77% of all HCV monoinfected patients and 53.8% of HCV-HIV coinfected but none of genotype 3. There was equal fibrosis regression in patients with mild to moderate fibrosis (F1/F2/F3) compared with those with advanced stage of fibrosis (F4). Moreover, all patients with improved fibrosis regression also had improved bilirubin and transaminase levels. There was no relation between platelet count and fibrosis regression. Conclusion It is likely that patients included here had a worse fibrosis stage at baseline. However, we can conclude that fibrosis regression in HCV patients can be reversed with the new DAAs, regardless of the stage but dependent on genotype. Moreover, patients with improved fibrosis regression also experience a decrease in transaminases. No conflict of interest

CP-155

PREVALENCE AND EFFECTIVENESS OF ANTIRETROVIRAL TREATMENT COMBINATIONS USED IN HIV PATIENTS NOT INCLUDED IN GUIDELINES

1

L Ruiz Gonzalez*, 1A Alvarez Nonay, 2M Torralba Gonzalez de Suso, 2M Rodriguez Zapata, AM Horta Hernandez, 1A Lazaro Lopez. 1Guadalajara University Hospital, Pharmacy, Guadalajara, Spain; 2Guadalajara University Hospital, Internal Medicine, Guadalajara, Spain

1

10.1136/ejhpharm-2017-000640.154

A69

Abstracts Background Most studies in HIV infected patients focus on the effectiveness of antiretroviral therapy (ART) combinations included in clinical guidelines. However, few studies have analysed combinations not listed in these guidelines. Purpose To analyse the prevalence and effectiveness of ART combinations not included in HIV guidelines. Material and methods A retrospective observational study was carried out between January 2014 and December 2015. All patients with ART followed for at least 1 year by the outpatient pharmacy were included. ART were classified in two groups:(1) all combinations listed in the Spanish National AIDS Plan Recommended Guidelines (GESIDA) for initial antiretroviral therapy 2014–2015; and combinations not listed in GESIDA Guidelines. To determine the effectiveness of the treatment, plasma viral load (VL) and CD4+ lymphocytes were reviewed. Two analyses according to different criteria were conducted:(1) criteria reflected in Spanish GESIDA guidelines: VL 300 cells/mL, on at least two consecutive occasions;(2) criteria reflected in the American DHHS guidelines: VL 300 cells/mL, on at least two consecutive occasions. Data were analysed with SPSS 20.0 software. Results 245 patients were analysed. 68.6% (168) were men. The median age was 48.5 years (IIC: 43.5 to 53).

Patients

ART combinations

ART combinations

included in

not included in

guidelines

guidelines

Total (n (%))

224 (91.4)

21 (8.6)

VL 300 cells/mL (n

3.174

(%)) VL 300 cells/mL (n

4.545

(%))

p=0.253

Conclusion This study shows that few patients receive ART combinations not included in clinical practice guidelines. The high power of current ART could explain the similar effectiveness between the listed and non-listed therapies in the guidelines.

CP-156

EVOLUTION OF CONSUMPTION OF THREE ANTIBIOTICS CLASSES AND OF THE RESISTANCE OF ESCHERICHIA COLI TO THESE CLASSES

1

A Cheikh*, 2 M Bouatia, 3A Ababou, 1Y Cherrah, 4A Benaouda, 5A El Hassani. 1Abulcasis University-Faculty of Pharmacy, Rabat, Morocco; 2Mohammed V University-Faculty of Medicine and Pharmacy, Paediatric Hospital, Rabat, Morocco; 3Abulcasis University, Cheikh Zaid Hospital-Intensive Care, Rabat, Morocco; 4Abulcasis University, Microbiology, Rabat, Morocco; 5Mohammed V University-Faculty of Medicine and Pharmacy, Cheikh Zaid Hospital, Rabat, Morocco 10.1136/ejhpharm-2017-000640.155

Background Antibiotic bacterial resistance is one of the major challenges for hospitals worldwide. Escherichia coli (E coli) is the main bacterial germ in healthcare services in our hospital. this bacteria has changed its sensitivity to different antibiotic classes remarkably in the last decades. Purpose Our objective was to study consumption of three classes of antibiotics: penicillins (amoxicillin and amoxicillin/ clavulanic acid), cephalosporines (ceftriaxone and ceftazidim) and quinolones (ciprofloxacin), and also to study the evolution of E coli resistance to these three classes of antibiotics. Material and methods We studied consumption of the three antibiotic classes using daily defined dose (DDD) per 1000 hospitalisation days between 2006 and 2015. Also, we monitored the change in E coli resistance to these three classes between 2009 and 2015 using the WHONET 5.3 percentage of resistant strains with respect to all the strains collected. Results 3603 E coli strains were collected (57% of BGN). Consumption of the three antibiotics classes and E coli resistance to these molecules are summarised in the table. Conclusion E coli resistance to the three antibiotic classes has increased over the years. Selection pressure is one of the most important reasons for this evolution of resistance and the high antibiotic consumption. The increasing resistance of E coli to penicillins has pushed consumption towards other classes, such as the cephalosporines and quinolones, increasing consumption of these two classes which will undoubtedly accelerate the emergence of bacterial resistance phenomenon to cephalosporins and fluoroquinolones. Consequently, close monitoring of antibiotic consumption must be established by hospital pharmacists. REFERENCES AND/OR ACKNOWLEDGEMENTS Acknowledgements to microbiology team.


No conflict of interest 2006

2007

2008

2009

2010

2011

2012

2013

2014

2015

Resistance to penicillins

36%

35%

41%

60%

53%

55%

49%

Resistance to third

11%

11%

8%

12%

10%

17%

16%

27%

26%

20%

27%

25%

31%

30%

generation cephalosporins Resistance to fluoroquinolones Penicillins

415

440

404

401

334

338

358

338

389

384

Cephalosporins

59

93

110

108

102

96

105

110

135

141

Fluoroquinolones

130

124

143

196

162

167

153

177

179

201

A70


Abstracts CP-157

RISK FACTORS ASSOCIATED WITH THROMBOEMBOLIC DISEASE IN HOSPITALISED PATIENTS: AN ASSESSMENT IN A GENERAL SPECIALTIES HOSPITAL

MI Sierra Torres, CM Valencia Soto, R Sánchez del Moral, MD Toscano Guzmán, E Sánchez Gómez, C Bocanegra Martín*. Complejo Hospitalario Huelva Hospital Juan Ramón Jimenez Y Hospital Infanta Elena, Pharmacy Department, Huelva, Spain 10.1136/ejhpharm-2017-000640.156

Background Thromboembolic disease (TED) is a complex condition in which the interaction between genetic, acquired and environmental factors determines the onset of an episode. Purpose This study aimed to assess the risk factors (RF) associated with TED in hospitalised patients. Material and methods A retrospective, descriptive study was conducted in which hospitalised patients with TED from January 2015 to June 2015 were included. Variables included: age, sex, type of TED, previous events, hospitalisation duration, D-dimer elevation, obesity, renal impairment, tabaquism, cardiac and respiratory comorbidities, recent immobilisation or major surgery, family history/genetic predisposition, oncohaematologic history, and treatment with chemotherapy regimens, hormonal therapy, angiogenic agents or erythropoiesis stimulating factors (ESF). Data were obtained from electronic prescription software (APD-Prisma) and medical records. Results 108 patients were analysed. There were 6.8 new cases per 1000 admitted patients during the study period. 55% were women. Mean age was 71 years (18–97). 20.3% presented previous TED. Median time of hospitalisation was 8 days (1–91). D-dimer elevation was observed in 63.8% with an average value of 6926.91 (2-48453) (26% absent data). Of 108 patients, 40.7% presented tabaquism, 22% respiratory complications, 21% cardiac comorbidities, 14.8% obesity and 11% renal impairment. Recent immobilisation or major surgery was noted in 27.8% and 4.6% of cases, respectively. A family history of TED or genetic predisposing mutations were present in 7.4%. Oncohaematologic history was observed in 24%. 8.3% received chemotherapy, 6.5% hormonal therapy and 6.5% ESF. No patient received angiogenic therapy. 28 days mortality was 7.4%. Conclusion Among our studied population, the incidence of TED was an important issue that grew according to genetic, acquired or environmental factors, consistent with published data. RF evaluation is an essential measure during hospitalisation to minimise these events. Multidisciplinary active programmes for TED prevention should be available. No conflict of interest

CP-158

USE OF ANTIRETROVIRAL DUAL THERAPY AS AN ANTIRETROVIRAL TREATMENT SWITCH STRATEGY. EXPERIENCE IN A COMMUNITY HOSPITAL

1

M Perpinya*, 2J Colomer, 2A Gomez, 2I Vilaro. 1Hospital, Pharmacy, Salt, Spain; 2Hospital, Infectious Diseases, Salt, Spain

10.1136/ejhpharm-2017-000640.157

Background Dual therapy (DT) can be a therapeutic option for antiretroviral therapy (ART) in the case of resistance, simplification, toxicity and adherence compliance. Purpose The purpose of this study was to analyse the causes that led to a change in DT, the combinations used and course of viral


load (VL) and CD4+ count, as well as the degree of adherence before and after the change. Material and methods A retrospective observational study was conducted between March 2013 and March 2016. All patients who had been treated for at least 24 weeks with ART with DT were retrieved from the hospital´s pharmacy database. Epidemiological and laboratory data for VL and CD4+, and level of adherence prior to switching to DT and at study completion were retrieved from the clinical management programme. Treatment related information was obtained from the pharmacy´s database. A descriptive statistical analysis was performed. A central tendency is expressed, with median and minimum and maximum values. Results Of 267 patients on ART, 20 (7.5%) were switched to DT. Before the switch, 14 (70%) patients had VL