Elrefaei Hazem, El Nekidy Wasim S, Nasef Rama, Motasem Manal, Mkarim Yara, Al Quteimat Osama, Hisham Mohamed, Ismail Rami, Abidi Emna, Afif Claude, El Lababidi Rania
Department of Pharmacy Services, Cleveland Clinic Abu Dhabi, Abu Dhabi P.O. Box 112412, United Arab Emirates.
Cleveland Clinic Lerner College of Medicine, Cleveland, OH 44106, USA.
Antibiotics (Basel). 2024 Oct 16;13(10):974. doi: 10.3390/antibiotics13100974.
Extending a consistent pharmacy antimicrobial stewardship weekend service was a newly implemented initiative. We sought to evaluate the impact of incorporating an Infectious Diseases (ID)-trained clinical pharmacist into an antimicrobial stewardship program (AMS) during weekends.
The number of documented interventions was 451 on 362 patients compared to 115 interventions on 108 patients during the pre-implementation period ( = 0.04), with interventions primarily targeting Watch antibiotics, as classified by the WHO AWaRe classification. A reduction in the LOS was observed, with a median of 16 days (8-34) during the post-implementation period compared to 27.5 days (10-56) during the pre-implementation period ( = 0.001). The median DOT increased during the post-implementation period to 8 (6-11), versus the increase to 7 (4-11) during the pre-implementation period ( ≤ 0.001). Finally, there was no significant difference observed in healthcare-associated CDI and infection-related readmission.
This is a retrospective single-center, pre-post quasi-experimental study. Data including the documented pharmacist interventions were collected from the electronic medical record (EMR), the pre-implementation phase was in 2020, and post-implementation was in 2021. The primary outcome was to identify the number of AMS interventions through prospective audit and feedback review analysis. Secondary outcomes included antibiotic days of therapy (DOT), length of hospital stay (LOS), healthcare-associated infection (CDI), and infection-related readmission.
The pharmacist-driven weekend AMS is an opportunity for pharmacists to intervene and optimize patients' care plans. This initiative demonstrated significant increased AMS-related interventions, promoted judicious antimicrobial use, and contributed to a reduced length of hospital stay. Our findings need to be replicated in a larger prospective study.
推广持续的药房抗菌药物管理周末服务是一项新实施的举措。我们试图评估在周末将一名接受过传染病（ID）培训的临床药师纳入抗菌药物管理计划（AMS）的影响。
记录的干预措施在实施后阶段有451次，涉及362名患者，而在实施前阶段为115次，涉及108名患者（P = 0.04），干预措施主要针对世界卫生组织AWaRe分类中的观察类抗生素。观察到住院时间缩短，实施后阶段中位数为16天（8 - 34天），而实施前阶段为27.5天（10 - 56天）（P = 0.001）。实施后阶段给药天数（DOT）中位数增加到8天（6 - 11天），而实施前阶段增加到7天（4 - 11天）（P≤0.001）。最后，在医疗保健相关的艰难梭菌感染（CDI）和感染相关的再入院方面未观察到显著差异。
这是一项回顾性单中心前后对照准实验研究。从电子病历（EMR）收集包括记录的药师干预措施在内的数据，实施前阶段为2020年，实施后阶段为2021年。主要结果是通过前瞻性审核和反馈审查分析确定AMS干预措施的数量。次要结果包括抗生素治疗天数（DOT）、住院时间（LOS）、医疗保健相关感染（CDI）和感染相关的再入院。
由药师推动的周末AMS是药师进行干预并优化患者护理计划的契机。该举措显示与AMS相关的干预措施显著增加，促进了抗菌药物的合理使用，并有助于缩短住院时间。我们的研究结果需要在更大规模的前瞻性研究中得到验证。
