(C-086) Evaluating the Impact of GAAT Criteria on the Development of Antimicrobial Resistance in ICU Patients Receiving Parenteral Antimicrobial Therapy

Background: The development of Antimicrobial Resistance (AMR) in hospital settings, particularly in ICU patients, is a growing concern. The Glasgow Antimicrobial Audit Tool (GAAT) criteria is a framework used to assess the appropriateness of parenteral antimicrobial therapy.

Objectives: This study aimed to determine the association between the appropriateness of parenteral antimicrobial therapy as measured by the GAAT criteria and the development of AMR in ICU patients.

Methods: A retrospective case-control study was conducted in the ICU of a private tertiary care hospital in North India, including patients who received antimicrobial therapy. Antimicrobial prescriptions were reviewed and classified based on GAAT criteria for appropriateness. AMR development was monitored through microbial cultures and resistance patterns. Patients with resistant infections were classified as cases, while those with susceptible infections or no infections were controls. Statistical analyses, including chi-square tests and logistic regression, assessed the association between GAAT adherence and AMR development. Statistical analyses, including chi-square tests and logistic regression, were used to assess the association between GAAT adherence and AMR development. The analysis was performed using R software.

Results: A total of 8010 ICU patients were screened. The GAAT criteria was only applicable to 85.75% (2938/3426) of cases and 95.65% (4385/4584) of controls. Further, out of 2938 cases and 4385 controls, in 78.48% of cases and 86.15% of controls, the parenteral AMDs were found appropriate according to GAAT criteria. The majority of infections in cases were caused by Escherichia coli (48.37%) followed by Staphylococcus aureus (16.14%), Acinetobacter baumannii (14.39%), Pseudomonas aeruginosa (14.89%) and Klebsiella pneumoniae (13.63%). Adherence to the GAAT criteria (OR: 0.41, 95% CI: 0.12-0.78) was identified as a protective factor for the development of AMR.

Conclusions: Adherence to GAAT criteria in parenteral antimicrobial therapy is associated with a reduced risk of AMR in ICU patients, highlighting the importance of antimicrobial stewardship and standardized protocols in high-risk hospital settings.