Impact of clinical pharmacist‐led antibiotic stewardship program on clinical outcomes in a tertiary referral hospital. (27th July 2021)

• Record Type: Journal Article
• Authors: Tabarsi, Payam; Jamaati, Hamidreza; Yousefian, Sahar; Marjani, Majid; Moniri, Afshin; Langari, Zahra Mirshafiei; Haghgoo, Roodabeh; Eskandari, Raha; Toutkaboni, Mihan Pourabdollah; Dastan, Farzaneh
• Is Part Of: Journal of pharmacy practice and research. Volume 51:Number 6(2021)
• Page Start: 456
• Page End: 463
• Publication Date: 2021-07-27
• Subjects: antibiotic stewardship program (ASP) -- clinical pharmacist -- clinical outcome -- economic outcome -- antibiotics; Hospital pharmacies -- Australia -- Periodicals; Pharmacy -- Periodicals; Pharmacology -- Periodicals; 615.1
• DOI: 10.1002/jppr.1731
• Languages: English
• ISSNs: 1445-937X

Abstract

Abstract: Aims: To evaluate the clinical outcomes of a clinical pharmacist‐led antibiotic stewardship program (ASP). Methods and Results: A prospective study of the ASP implementation, consisting of four broad‐spectrum antibiotics (meropenem, imipenem, vancomycin and colistin) was performed in a tertiary referral, university‐affiliated hospital in Tehran, Iran. Four hundred patients were included in the study via a simple randomisation method, over two six‐month periods before ( n = 200) and after ( n = 200) ASP implementation. Clinical outcome, inappropriate antibiotic use, expenditure, and antibiotic resistance were assessed between two periods. A total of 349 patients were assessed after exclusion of patients who fulfilled exclusion criteria, of which 171 patients (49%) were included in the intervention period. Baseline characteristics between the two periods were similar except for mean severity score (3.64 ± 2.80 pre vs. 4.29 ± 2.88 post P < 0.03). There was a 17.67% decrease in inappropriate antibiotic use ( P = 0.17). Length of stay (LOS) was shortened by 3.50 days ( P = 0.93). Total cost was reduced by 21.58% and inappropriate cost was significantly declined from US$20 853.93 to US$14 482.76 ( P = 0.04). Indeed, US$32.50 was saved per patient in six months. Mean days of therapy (DOT)/1000 patient‐days and defined daily dose (DDD)/1000 patient‐days were reduced by 6.90% and 12.77%, respectively ( P > 0.05). Furthermore, antibiotic resistance was decreased by 33.62% over this short period. Conclusion: These results demonstrate that the potential role of the clinical pharmacist in implementing an ASP, and the resultant rational use of antibiotics, can provide considerable clinical and economic benefits.