Impact of Pharmacist-Led Anti-Infective Consultations on Therapeutic Outcomes: A Retrospective Cohort Study in a Tertiary Hospital.

OBJECTIVE

To evaluate the clinical and economic impact of pharmacist-led anti-infective consultations in a Chinese tertiary hospital under diagnosis-related group (DRG) payment reforms.

METHODS

This retrospective cohort study analyzed inpatients receiving pharmacist-led anti-infective consultations from Tongde Hospital of Zhejiang Province in 2024. Patients were stratified into adherence and non-adherence groups based on clinicians' implementation of pharmacist recommendations. Outcomes included clinical response rates, adverse drug reactions (ADRs), 14-day mortality, total costs of antimicrobial therapy and total hospitalization costs.

RESULTS

In this study, clinical pharmacists conducted 498 anti-infective therapy consultations for 313 patients, with 82.13% (409/498) of their recommendations being accepted by clinicians. The results demonstrated that adherence to clinical pharmacist recommendations significantly enhanced the clinical response rate (81.99% vs 38.46%, p < 0.05), decreased the incidence of adverse drug reactions (4.21% vs 13.46%, p< 0.05), and reduced 14-day mortality (5.75% vs 17.31%, p< 0.05). Furthermore, adherence led to a 69% reduction in the average cost of antimicrobial therapy ($1830.79 vs $5983.14, p< 0.05) and a 58% decrease in the average total cost of hospitalization ($15,306.17 vs $36,799.11, p< 0.05).

CONCLUSION

Pharmacist-led anti-infective consultations demonstrate efficacy in enhancing infection treatment outcomes and curbing antimicrobial expenditures, providing actionable evidence for scaling antimicrobial stewardship programs in one DRG-based hospital in China.