The Impact of Clinical Pharmacist-Driven Weekend Antimicrobial Stewardship Coverage at a Quaternary Hospital.

IF 4.3 2区医学 Q1 INFECTIOUS DISEASES Antibiotics-Basel Pub Date : 2024-10-16 DOI:10.3390/antibiotics13100974

Hazem Elrefaei, Wasim S El Nekidy, Rama Nasef, Manal Motasem, Yara Mkarim, Osama Al Quteimat, Mohamed Hisham, Rami Ismail, Emna Abidi, Claude Afif, Rania El Lababidi

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Abstract

Background and objective: Extending a consistent pharmacy antimicrobial stewardship weekend service was a newly implemented initiative. We sought to evaluate the impact of incorporating an Infectious Diseases (ID)-trained clinical pharmacist into an antimicrobial stewardship program (AMS) during weekends.

Results: The number of documented interventions was 451 on 362 patients compared to 115 interventions on 108 patients during the pre-implementation period (p = 0.04), with interventions primarily targeting Watch antibiotics, as classified by the WHO AWaRe classification. A reduction in the LOS was observed, with a median of 16 days (8-34) during the post-implementation period compared to 27.5 days (10-56) during the pre-implementation period (p = 0.001). The median DOT increased during the post-implementation period to 8 (6-11), versus the increase to 7 (4-11) during the pre-implementation period (p ≤ 0.001). Finally, there was no significant difference observed in healthcare-associated CDI and infection-related readmission.

Methods: This is a retrospective single-center, pre-post quasi-experimental study. Data including the documented pharmacist interventions were collected from the electronic medical record (EMR), the pre-implementation phase was in 2020, and post-implementation was in 2021. The primary outcome was to identify the number of AMS interventions through prospective audit and feedback review analysis. Secondary outcomes included antibiotic days of therapy (DOT), length of hospital stay (LOS), healthcare-associated Clostridioides difficile infection (CDI), and infection-related readmission.

Conclusions: The pharmacist-driven weekend AMS is an opportunity for pharmacists to intervene and optimize patients' care plans. This initiative demonstrated significant increased AMS-related interventions, promoted judicious antimicrobial use, and contributed to a reduced length of hospital stay. Our findings need to be replicated in a larger prospective study.

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临床药剂师驱动的周末抗菌药物管理覆盖对一家四级医院的影响。

背景和目的：扩展药房抗菌药物管理周末服务是一项新实施的举措。我们试图评估在周末将一名经过传染病（ID）培训的临床药剂师纳入抗菌药物管理计划（AMS）的影响：有记录的干预次数为 451 次，涉及 362 名患者，而实施前为 115 次，涉及 108 名患者（p = 0.04），干预主要针对世界卫生组织 AWaRe 分类中的观察抗生素。据观察，住院时间有所缩短，实施后的中位数为 16 天（8-34 天），而实施前为 27.5 天（10-56 天）（p = 0.001）。实施后的 DOT 中位数增至 8 天（6-11 天），而实施前为 7 天（4-11 天）（p ≤ 0.001）。最后，在医源性 CDI 和感染相关再入院方面没有观察到明显差异：这是一项回顾性的单中心、前-后准实验研究。从电子病历（EMR）中收集了包括药剂师干预记录在内的数据，实施前阶段为 2020 年，实施后阶段为 2021 年。主要结果是通过前瞻性审计和反馈审查分析确定 AMS 干预的数量。次要结果包括抗生素治疗天数（DOT）、住院时间（LOS）、医源性艰难梭菌感染（CDI）和感染相关再入院率：药剂师主导的周末 AMS 为药剂师提供了干预和优化患者护理计划的机会。这一举措显著增加了 AMS 相关干预措施，促进了抗菌药物的合理使用，并有助于缩短住院时间。我们的研究结果需要在更大规模的前瞻性研究中得到验证。

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来源期刊

Antibiotics-Basel Pharmacology, Toxicology and Pharmaceutics-General Pharmacology, Toxicology and Pharmaceutics

CiteScore

7.30

自引率

14.60%

发文量

1547

审稿时长

11 weeks

期刊介绍： Antibiotics (ISSN 2079-6382) is an open access, peer reviewed journal on all aspects of antibiotics. Antibiotics is a multi-disciplinary journal encompassing the general fields of biochemistry, chemistry, genetics, microbiology and pharmacology. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on the length of papers.