Background/Rationale Western Sussex hospital trust recommends the concurrent use of amoxicillin/teicoplanin, metronidazole and gentamicin for the treatment of intra-abdominal sepsis.

Standards Adult Antimicrobial Guide Western Sussex Hospitals NHS Foundation Trust Drug recommended: Amoxicillin/Teicoplanin, Metronidazole and Gentamicin. Duration: 5–7 days. Dose of Gentamicin: 5 mg/kg Lean Body Weight. Monitoring – 6 to 14 hour post Gentamicin levels and subsequent 2 other levels with the week.

Aims/Objectives Determine correct prescribing and monitoring of gentamicin Present findings at the Surgical Clinical Governance.

Method Retrospectively data collection.

Analysis 36 patients.

Monitoring 25 (69%) – monitoring within the recommended window, 6 (17%) – missed monitoring, 5 (14%) – delayed, 11 (31%) missed/delayed monitoring was due to: A break of continuity of prescription after the first dose due to insufficient drug handover. late prescribing which causes blood sampling at inconvenient times.

Dosing 17 (47%) – Weight/Height recorded, 19 (19%) – No Weight/Height recorded, 8 (22%) – Dose changed, 28 (78%) -dose maintained. Missing data contributed to inappropriate patient dosing.

Antibiotic course 11 (31%) – 5–7 days, 21 (58%) –<5 days, 4 (11%) –>7 days.

Concurrent Antibiotics 36(100)-Amoxicillin/Teicoplanin and Metronidazole. 17 (47%) – 5–7 days, 16 (44%) –>7 days, 3 (8%) –<5 days.

Conclusion 58% received gentamicin for less than the recommended course length, 69% had appropriate gentamicin monitoring.

Outcome I was able to strategize practical ways of improving future outcome and with the help of the audit team, interventions were commenced which led to sustainable system improvement.