Institute for Health and Rehabilitation Sciences, Ludwig Maximilians University, Munich, Germany.
Pharmacoepidemiol Drug Saf. 2011 Jul;20(7):739-46. doi: 10.1002/pds.2126. Epub 2011 Mar 30.
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.
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.
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.
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.
本研究旨在通过前瞻性对照干预研究评估药剂咨询对医院外科部门抗菌药物使用质量的影响。
接受药物干预的患者（干预组，IG，n=317）与历史对照组（CG，n=321）进行比较。在对照期间，无需干预即可监测抗菌药物的使用情况。在随后的干预期间，临床药师审查处方并提供药物使用建议。
干预减少了抗菌药物疗程（IG=10 天，CG=11 天，静脉与口服的发生率比为 0.88，95%置信区间 0.84 至 0.93）和静脉给药时间（IG=8 天，CG=10 天，从静脉给药转换为口服给药的风险比为 1.76，95%置信区间 1.23 至 2.52）。干预还有助于避免不必要的联合治疗，并降低抗菌药物的总成本。
审查处方的临床药师可以提高效率，例如缩短治疗疗程。基于病房的临床药师的咨询被证明可以有效地简化外科病房的抗菌药物治疗，并提高药物安全性。
