The Impact of Pharmacist-Led Antimicrobial Stewardship Review of Cultures in the Ambulatory Setting at a Comprehensive Cancer Center.

IF 0.8 Q4 PHARMACOLOGY & PHARMACY Hospital Pharmacy Pub Date : 2023-08-01 Epub Date: 2023-01-20 DOI:10.1177/00185787221150920
Deema H Abdelrahman, Aseel K AbuSara, Dina S Khabour
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Abstract

Background: Several antimicrobial stewardship interventions have demonstrated improved clinical outcomes. Though the impact of a pharmacist-led antimicrobial stewardship review of cultures has been described, studies have not evaluated such an intervention in institutions that primarily serve cancer patients. Aim: To describe the impact of the antimicrobial stewardship pharmacist's review of microbiological cultures from adult cancer patients in the ambulatory setting. Method: A retrospective study at a comprehensive cancer center that included adult cancer patients with positive microbiological cultures treated in the ambulatory setting, between August 2020 and February 2021. The cultures were reviewed in real time by the antimicrobial stewardship pharmacist, and were assessed for appropriateness of treatment. The number of antimicrobial modifications made, type of modifications, and physicians' acceptance rate were recorded. Results: A total of 661 cultures from 504 patients were reviewed by the pharmacist. The mean age of patients was 58 years ± 16 (SD); most had solid tumors (95%), and 34% were recent recipients of chemotherapy. Among the reviewed cultures, 175 (26%) required antimicrobial therapy modification, with an acceptance rate of 86%. The modifications consisted of changing from non-susceptible to susceptible antimicrobials (n = 95, 54%), initiation (n = 61, 35%), discontinuation (n = 10, 6%), de-escalation (n = 7, 4%), and dose modification (n = 2, 1%) of antimicrobials. Conclusion: Around one fourth of the cultures reviewed by the antimicrobial stewardship pharmacist in the ambulatory setting required interventions to optimize therapy. Future studies should evaluate the impact of these interventions on clinical outcomes.

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药剂师主导的抗菌药物管理审查对综合癌症中心门诊环境中培养物的影响。
背景:一些抗菌药物管理干预措施已证明可改善临床疗效。虽然已有研究描述了药剂师主导的抗菌药物管理培养物审查的影响,但尚未有研究对主要服务于癌症患者的机构进行此类干预的评估。目的:描述抗菌药物管理药剂师在非住院环境中对成年癌症患者的微生物培养进行审查的影响。方法:在一家综合医院进行回顾性研究:在一家综合癌症中心开展回顾性研究,研究对象包括 2020 年 8 月至 2021 年 2 月期间在非住院环境中接受治疗且微生物培养呈阳性的成年癌症患者。抗菌药物管理药剂师对培养结果进行实时审查,并评估治疗的适当性。对抗菌药物修改的数量、修改类型和医生的接受率进行了记录。结果药剂师共审查了 504 名患者的 661 份培养物。患者的平均年龄为 58 岁 ± 16(标清);大多数患者患有实体瘤(95%),34%的患者近期接受过化疗。在复查的培养物中,有 175 份(26%)需要调整抗菌治疗方案,接受率为 86%。调整包括从非易感抗菌药改为易感抗菌药(95 人,54%)、开始使用(61 人,35%)、停用(10 人,6%)、降级(7 人,4%)和调整抗菌药剂量(2 人,1%)。结论在门诊环境中,抗菌药物管理药剂师审查的培养物中约有四分之一需要采取干预措施来优化治疗。未来的研究应评估这些干预措施对临床结果的影响。
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来源期刊
Hospital Pharmacy
Hospital Pharmacy PHARMACOLOGY & PHARMACY-
CiteScore
1.70
自引率
0.00%
发文量
63
期刊介绍: Hospital Pharmacy is a monthly peer-reviewed journal that is read by pharmacists and other providers practicing in the inpatient and outpatient setting within hospitals, long-term care facilities, home care, and other health-system settings The Hospital Pharmacy Assistant Editor, Michael R. Cohen, RPh, MS, DSc, FASHP, is author of a Medication Error Report Analysis and founder of The Institute for Safe Medication Practices (ISMP), a nonprofit organization that provides education about adverse drug events and their prevention.
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