Background Since April 2014, an antimicrobial stewardship programme (ASP) has been implemented in hospitalisation units in a 580 bed hospital. The ASP team comprises two clinical pharmacists, two infectious diseases physicians and two microbiologists who, through weekly meetings, carry out their activities. The reasons for intervention are: not justified associations, dosing, pharmacokinetic monitoring, duration of antibiotic use more than 8 days and inappropriate prescription as indication and/or sensitivity testing.
Purpose The aim was to assess the degree of acceptance of interventions in antibiotic therapy mediated through the multidisciplinary team compared with those developed by the hospital pharmacy department. As a secondary objective, we analysed the type of interventions developed and the impact of ASP activity on consumption of antibiotics.
Material and methods This was a retrospective observational study from its implementation period to February 2016. The hospital pharmacy department selected patients treated with antibiotics suitable for optimisation through the unit dose drug distribution and pharmacokinetics area, and depending on the degree of urgency, the intervention was direct (by contacting the prescriber orally or in writing) or through weekly meetings with the multidisciplinary team. As a pharmacoeconomic indicator, the number of defined daily doses (DDD)/100 days bed was estimated monthly, and the decline on the impact on healthcare that led to the implementation of the programme was quantified. Results are expressed as mean (SD) for quantitative variables and percentages for qualitative variables. A statistical study was performed using the χ2 test for qualitative variables using STATA/IC-14.1.
Results After 22 months of implementation, 289 episodes in 216 patients (aged 64.8 years, SD=18.1) was proposed to optimise antibiotic therapy. Interventions mediated by the multidisciplinary group were more accepted than those mediated directly by the hospital pharmacy department (83% vs 39%; p <0.001). Acceptability in surgical and medical services was 56% and 48%, respectively. The type of intervention was: pharmacokinetics (35%), dose (30%), indication (12%), duration (12%) and association (11%). The annual NDD/100 days bed in monitoring antibiotic was reduced by 17% following the implementation of the ASP.
Conclusion The significantly greater efficiency of the interventions in the optimisation of antibiotic therapy mediated through multidisciplinary programmes was demonstrated.
No conflict of interest
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