Impact of the pharmacist on a multidisciplinary team in an antimicrobial stewardship program: a quasi-experimental study

Int J Clin Pharm. 2012 Apr;34(2):290-4. doi: 10.1007/s11096-012-9621-7. Epub 2012 Mar 1.


Background: Antimicrobial stewardship programs (ASP) have been implemented to promote rational use of antimicrobial drugs. Multidisciplinary teams are needed to form effective committees.

Objective: Assess the impact of ASP, with and without the presence of a pharmacist, in a cardiology hospital in Brazil.

Methods: The program started with an infectious disease (ID) physician, and after 22 months, a pharmacist started to work in the ASP team. We present data related to: stage 1-before the program implementation; stage 2-with the ID physician; and stage 3 with the inclusion of a pharmacist. Analysis was made by segmented regression of time series.

Results: After the start of ASP there was a significant reduction of consumption of all antimicrobials. The pharmacist contributed to the significant reduction in consumption of fluoroquinolones, clindamycin and ampicillin/sulbactam and in increase in total cephalosporins use in stage 3. Adherence rate to the ASP team recommendations was 64.1%. There was a significant reduction of 69% in hospital antibiotics costs.

Conclusion: A non-expensive ASP in a limited resource country resulted in reductions in antimicrobial consumption and costs. The multidisciplinary team contributed to maximize the impact of interventions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Infective Agents / economics
  • Anti-Infective Agents / therapeutic use*
  • Brazil
  • Chi-Square Distribution
  • Cost Savings
  • Cost-Benefit Analysis
  • Developing Countries
  • Drug Costs
  • Drug Utilization
  • Drug Utilization Review
  • Guideline Adherence
  • Hospital Costs
  • Humans
  • Interdisciplinary Communication
  • Organizational Objectives
  • Patient Care Team / economics
  • Patient Care Team / organization & administration*
  • Patient Care Team / standards
  • Pharmacists / economics
  • Pharmacists / organization & administration*
  • Pharmacists / standards
  • Pharmacy Service, Hospital / economics
  • Pharmacy Service, Hospital / organization & administration*
  • Pharmacy Service, Hospital / standards
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'* / standards
  • Program Evaluation
  • Prospective Studies
  • Regression Analysis
  • Time Factors


  • Anti-Infective Agents