Category: Professional Posters
Purpose: The misuse or overuse of antimicrobials is known to be associated with poor clinical outcomes. To ensure appropriate antimicrobial use, an antimicrobial stewardship program (AMS) has been implemented in various countries, and specialized pharmacists have been proposed as core members of the AMS; however, the participation of pharmacists in the AMS is limited to some institutions in Korea. Therefore, we aimed to evaluate the pharmacist interventions for antimicrobial use for hospitalized patients by conducting a multicenter, retrospective study. In addition, we investigated the effect of having a dedicated pharmacist of AMS on the rate of pharmacist interventions for antimicrobial use.
Methods: This study is a multicenter, retrospective analysis performed using documented pharmacist interventions for antimicrobials use between January 2017 and December 2017. Five tertiary teaching hospitals participated in this study. The type of drug-related problem (DRP) and clinical significance of the pharmacist interventions were evaluated according to the Pharmaceutical Care Network Europe classification V8.01 (PCNE) and National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) criteria, respectively. In addition, we evaluated the acceptance rate of pharmacist interventions and the intervention rate. The correlation between the participation of a dedicated pharmacist in AMS and the intervention rate for antimicrobial use was evaluated by using multivariate logistic regression analysis.
Results: In total, 11,950 interventions were documented for 7,151 inpatients. The intervention rate based on the number of patients and the acceptance rate of pharmacist interventions was 6.3% (range 0.9%–10.4%) and 96.1% (range 82%–99%), respectively. The most prevalent DRP was “dose selection” (67.8%) followed by “drug selection” (19.8%). Approximately 77.5% of pharmacist interventions were classified beyond D of the NCC MERP index. The participation of a dedicated pharmacist in the AMS increased the likelihood of pharmacist intervention for antimicrobials (aOR, 3.58; 95% confidence interval, 2.55–5.06).
Conclusion: This study demonstrated that pharmacist interventions for antimicrobial use in hospitalized patients were widely accepted and were clinically significant. The participation of a dedicated pharmacist for AMS is expected to contribute to the safe and effective use of antimicrobials through interventions for antimicrobial prescriptions.