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Clinical pharmacy and clinical trials (including case series)
Hospital pharmacy resident collaboration in a clinical infectious diseases unit (CIDU))
  1. P. Gemio,
  2. S. Martin Clavo,
  3. L. Romero Soria,
  4. L. Braga Fuentes,
  5. L. Bravo García-Cuevas,
  6. M.J. Bernáldez Rey,
  7. F. Olgado Ferrero,
  8. J.F. Rangel Mayoral
  1. 1Infanta Cristina University Hospital, Farmacia, Badajoz, Spain
  2. 2Infanta Cristina University Hospital, Cirugía Traumatológica y Ortopédica, Badajoz, Spain
  3. 3Infanta Cristina University Hospital, Medicina Interna, Badajoz, Spain

Abstract

Background There are some hospitals in Spain where a pharmacist already belongs to a Antimicrobial Management Team (AMT), thus it is important and necessary that the Pharmacy Residency Program includes a rotation by the clinical infectious diseases unit.

Purpose To describe the experience and contribution of a third-year hospital pharmacy resident in the first rotation planned by an CIDU in an University Hospital.

Materials and methods During a month, a third-year resident accompanied the members of an CIDU in their daily workday, full time (from 8 am to 3 pm). The pharmacist resolved queries during the round up with physicians related to the patients admitted in their unit, the ones admitted in other units and those who attended to External consultations. Then, the pharmacist registered and assessed his pharmaceutical interventions (PI). The information collected was processed in an Access® database and classified according to these variables. The types of PI were: A: Sequential Therapy; B: Dosage adjustment in renal failure; C: Pharmacokinetics monitoring; D: Antibiotic switching according to best cost / effectiveness; E: Antibiotic switching according to better coverage; F: Medication administration; G: Drugs interaction. It was also estimated the PI by service, the acceptation and the savings with antibiotic switching according to best cost / efectiveness ratio.

Results During our study, 43 interventions were proposed, accepting 79% (34). Divided by our variables, the acceptance ratio was: A: 66.7% (6) B: 100% (4), C: 59% (8), E: 100% (9), F: 100% (2) and G: 100% (1).

According to clinical services, the distribution was: Postsurgical cardiovascular unit 25.6%, resuscitation 23.3%, cardiology 9.3%. general surgery 7%, pulmonology 4.7%, oncology 4.7%, neurology 2.3% and neurosurgery 2.3%. With D intervention (antibiotic interchange according to best cost / effectiveness ratio), 55.6% acceptation resulted in savings of 5285€ approximately.

Conclusions This rotation development experience has been positive, and it has been included in the Pharmacy Residency Program (PRP) in our hospital. This program could be a significant impact on patient care by becoming an integral part of the medical team by working directly on the hospital floors. Also, the pharmacist was provided more information about the patients, improving the PI's. Regarding the assessment of our interventions, we should highlight those related with antibiotic interchange according to best cost / effectiveness ratio and better efficacy, used to optimise antimicrobial therapy achieving both clinical and economical positive outcomes.

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