Impact of an infectious diseases pharmacist-led intervention on antimicrobial stewardship program guideline adherence at a Thai medical center
Issued Date
2022-08-01
Resource Type
ISSN
10792082
eISSN
15352900
Scopus ID
2-s2.0-85134854927
Pubmed ID
35390112
Journal Title
American Journal of Health-System Pharmacy
Volume
79
Issue
15
Start Page
1266
End Page
1272
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Health-System Pharmacy Vol.79 No.15 (2022) , 1266-1272
Suggested Citation
Jantarathaneewat K., Montakantikul P., Weber D.J., Nanthapisal S., Rutjanawech S., Apisarnthanarak A. Impact of an infectious diseases pharmacist-led intervention on antimicrobial stewardship program guideline adherence at a Thai medical center. American Journal of Health-System Pharmacy Vol.79 No.15 (2022) , 1266-1272. 1272. doi:10.1093/ajhp/zxac107 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86840
Title
Impact of an infectious diseases pharmacist-led intervention on antimicrobial stewardship program guideline adherence at a Thai medical center
Other Contributor(s)
Abstract
Purpose: To evaluate and compare antimicrobial stewardship program (ASP) guideline adherence (primary outcome) as well as length of stay, 30-day all-cause mortality, clinical cure, antimicrobial consumption, and incidence of multidrug-resistant (MDR) pathogens (secondary outcomes) between an infectious diseases (ID) pharmacist-led intervention group and a standard ASP group. Methods: A quasi-experimental study was performed at Thammasat University Hospital between August 2019 and April 2020. Data including baseline characteristics and primary and secondary outcomes were collected from the electronic medical record by the ID pharmacist. Results: The ASP guideline adherence in the ID pharmacist-led intervention group was significantly higher than in the standard ASP group (79% vs 56.6%; P < 0.001), especially with regard to appropriate indication (P < 0.001), dosage regimen (P = 0.005), and duration (P = 0.001). The acceptance rate of ID pharmacist recommendations was 81.8% (44/54). The most common key barriers to following recommendations were physician resistance (11/20; 55%) and high severity of disease in the patient (6/20; 30%). Compared to the standard ASP group, there was a trend toward clinical cure in the ID pharmacist-led intervention group (63.6% vs 56.1%; P = 0.127), while 30-day all-cause mortality (15.9% vs 1.5%; P = 0.344) and median length of stay (20 vs 18 days; P = 0.085) were similar in the 2 groups. Carbapenem (P = 0.042) and fosfomycin (P = 0.014) consumption declined in the ID pharmacist-led intervention group. A marginally significant decrease in the overall incidence of MDR pathogens was also observed in the ID pharmacist-led intervention group (coefficient, -5.93; P = 0.049). Conclusion: Our study demonstrates that an ID pharmacist-led intervention can improve ASP guideline adherence and may reduce carbapenem consumption.