Abstract:
UNLABELLED:Sequential antimicrobial therapy is an important part of antimicrobial stewardship and intends to improve the timeliness of switch to oral antimicrobials. The aim of this study was to assess the impact of the introduction of guidelines and criteria for switching to oral antimicrobials. SETTING:The study was conducted in a 753-bed academic hospital in Ireland. METHODS:The study was prospective and of controlled before and after design. Patients admitted under the care of a medical consultant were screened for inclusion. The study was divided into pre-intervention and post-intervention phases. Patients admitted and prescribed IV antimicrobials were enrolled into either a study group or control group. Post-intervention, the intervention to the study group consisted of application of stickers and criteria for switch to oral antimicrobial therapy to the drug chart. Pre-intervention in the study group and in both phases in the control group, conventional practice of clinical pharmacists reviewing drug charts and contacting prescribers to discuss a switch to an oral antimicrobial continued. The duration of intravenous treatment, the timeliness of switch to oral therapy, length of stay and cost savings were measured. MAIN OUTCOME MEASURE:The duration of intravenous antimicrobial therapy in the pre-intervention and post-intervention phases in both study and control groups. RESULTS:Pre-intervention, 85 courses of IV antimicrobials were prescribed to study group patients, compared to 60 in the control group. Post-intervention, there were 92 courses in the study group and 53 in the control group. The duration of IV antimicrobial treatment reduced significantly in the study group post-intervention, compared to the control group (P = 0.02). The timeliness of the switch also improved significantly in the study group post-intervention (P = 0.017). No improvement occurred in the control group. The median length of stay was not reduced post-intervention. Antimicrobial costs reduced by a mean of €6.41 in the study group post-intervention. CONCLUSION:This controlled before and after study demonstrates successful implementation of a pharmacist-led antimicrobial stewardship strategy. Duration of IV antimicrobial treatment reduced significantly and the timeliness of switch significantly improved. This study may be used as a template for the introduction of further pharmacist-led antimicrobial stewardship initiatives.
journal_name
Int J Clin Pharmjournal_title
International journal of clinical pharmacyauthors
Dunn K,O'Reilly A,Silke B,Rogers T,Bergin Cdoi
10.1007/s11096-010-9475-9subject
Has Abstractpub_date
2011-04-01 00:00:00pages
208-14issue
2eissn
2210-7703issn
2210-7711journal_volume
33pub_type
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,评审
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journal_title:International journal of clinical pharmacy
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更新日期:2020-04-01 00:00:00
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journal_title:International journal of clinical pharmacy
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更新日期:2015-06-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2012-06-01 00:00:00
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更新日期:2015-10-01 00:00:00
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更新日期:2011-04-01 00:00:00
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更新日期:2014-04-01 00:00:00
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更新日期:2016-10-01 00:00:00