Background Antimicrobial stewardship (ABS) aims to improve patient care and reduce unwanted results of antimicrobial overuse or misuse. Recent guidelines make specific recommendations for developing institutional programmes. Such programmes should be comprehensive, multidisciplinary, and use strategies that best fit local resources. Principal proactive strategies include interventions and feedback, formulary restrictions, education and informatics to support clinical decision making.
Purpose Such a programme was implemented at Barzilai Medical Centre. Its goals are to prevent unnecessary antibiotic use, optimise dosing, appropriate length of treatment and decrease drug expenditure. It uses a local integrated informatics tool, developed by a clinical pharmacist.
Materials and methods Our informatics tool provides full reports on all patients receiving antimicrobials, doses, lengths of treatment, bacteria susceptibility, laboratory values, all related to their diagnosis. Collected daily data is further evaluated by the Infectious Disease (ID) team and recommended interventions are followed up for implementation by clinical pharmacists.
Results 1373 interventions were performed during a one-year period (2012). Types of intervention included: adherence to treatment protocol (41.9%), length of treatment (37.2%), drug re-selection according to cultures (9.9%), dose optimisation (6.2%) and request/reminder for bacterial susceptibility (5.1%). Comparing pre- and post-intervention periods, antibiotic expenditure/patient was reduced by 9.9%.
Conclusions A successful antimicrobial stewardship programme enables a rich data base to be established that allows easy retrieval of all information regarding antimicrobial use in a hospital.
Informatics technology and a multidisciplinary team are efficient resources to make such programmes successful.
Informatics dramatically changed the job performance of the clinical pharmacist regarding involvement, performance and efficiency.
No conflict of interest.
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