Abstracts from the Atlantic Corridor Medical Student Research Conference, 7th November 2019

Abstract

Abstracts from the Atlantic Corridor Medical Student Research Conference, 7 November 2019s from the Atlantic Corridor Medical Student Research Conference, 7 November 2019 # Royal Academy of Medicine in Ireland 2019 Trends in Antimicrobial Prescribing Patterns for Acute Necrotizing Pancreatitis in a Non-specialist Centre;Which Guidelines to Follow? M. Shaikh Yousef , P. Kakodkar , V. Vikneswaramoorthy , R. Cafferkey , M. Ronan , W. Khan , I. Khan , R. Waldron , S. Sibartie , K.Barry 1, 4 1 Mayo Medical Academy, National University of Ireland Galway; 2 Department of Microbiology, Mayo University Hospital, Soalta Health Care Group, Castlebar, Ireland; 3 Department of Antimicrobial Pharmacy, Mayo University Hospital, Soalta Health Care Group, Castlebar, Ireland; 4 Department of Surgery, Mayo University Hospital, Soalta Health Care Group, Castlebar, Ireland Introduction: Local antimicrobial guidelines recommend considering ceftriaxone and metronidazole, in patients with acute necrotizing pancreatitis, admitted to the ICU, whereas several international guidelines and surgeons from national hepato-biliary (HPB) referral centres recommend using Carbepenems, which increase the risk of acquiring Carbapenemase Producing Enterobacterales (CPE). We aim to review the antimicrobial management of patients admitted to the ICU with acute necrotizing pancreatitis and assess the antimicrobial recommendation from national HPB centres. Methods: Treatment data of patients admitted to the ICU with query acute pancreatitis between September 2016 and February 2019 was extracted from a prospectively maintained microbiology electronic database for the following case series and consent was obtained. Results: Seventeen patients admitted to the ICU with query pancreatitis were included. Out of the 17 patients, 71%weremale (n= 12)with amedian age of 60 (36-80) years. Fifteen had radiologically confirmed acute pancreatitis; 8 of which had acute severe necrotizing pancreatitis (9 episodes). Meropenem was recommended in 37.5 % of the episodes (n=6), and 66.7 % of the time (n= 4), it was recommended by a national HPB centre. Leading on from that, the median duration of meropenem use was 5 days [range 3-14]. The most prescribed antibiotic for this cohort of patients was piperacillin/tazobactam, 81.8 % of the episodes. One patient acquired CPE. Conclusion: Meropenem should be used cautiously in acute necrotizing pancreatitis due to the associated risk of CPE.Moreover, there is a need to standardize antimicrobial usage for acute necrotizing pancreatitis in the