Effects of pharmaceutical counselling on antimicrobial use in surgical wards: intervention study with historical control group

Pharmacoepidemiol Drug Saf. 2011 Jul;20(7):739-46. doi: 10.1002/pds.2126. Epub 2011 Mar 30.

Abstract

Purpose: The objective of this study was to assess the impact of pharmaceutical consulting on the quality of antimicrobial use in a surgical hospital department in a prospective controlled intervention study.

Methods: Patients receiving pharmaceutical intervention (intervention group, IG, n = 317) were compared with a historical control group (control group, CG, n = 321). During the control period, antimicrobial use was monitored without intervention. During the subsequent intervention period, a clinical pharmacist reviewed the prescriptions and gave advice on medication.

Results: Intervention reduced the length of antimicrobial courses (IG = 10 days, CG = 11 days, incidence rate ratio for i.v. versus o.p. = 0.88, 95% confidence interval 0.84 to 0.93) and shortened i.v. administration (IG = 8 days, CG = 10 days, hazard rate = 1.76 in favour of switch from i.v. to p.o., 95% confidence interval 1.23 to 2.52). Intervention also helped to avoid useless combination therapy and reduced total costs for antimicrobials.

Conclusions: A clinical pharmacist who reviews prescriptions can promote an increase in efficiency, for example, by shortening the course of treatment. Counselling by ward-based clinical pharmacists was shown to be effective to streamline antimicrobial therapy in surgical units and to increase drug safety.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents / administration & dosage
  • Anti-Infective Agents / economics
  • Anti-Infective Agents / therapeutic use*
  • Drug Administration Schedule
  • Drug Costs
  • Female
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Pharmacists / organization & administration*
  • Pharmacy Service, Hospital / organization & administration
  • Practice Patterns, Physicians' / standards*
  • Professional Role
  • Prospective Studies
  • Quality Assurance, Health Care*
  • Surgery Department, Hospital / organization & administration
  • Surgery Department, Hospital / standards
  • Time Factors
  • Young Adult

Substances

  • Anti-Infective Agents