Antibiotic regimens tailored by clinical pharmacist supported by intensivist enhance rational use of antibiotics

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Abstract

Background
High antibiotics utility rates have been observed in surgical intensive care units (SICU). The present study was performed to evaluate the effect of engaging a clinical pharmacist in SICU on rational use of antibiotic treatment.
Methods
This retrospective quasi-experimental experiment involved 505 patients, over a period of one year, admitted to emergency department surgical/trauma ICU of a large tertiary care hospital. Before and during pharmacist participation periods of six months, 226 and 153 patients, respectively, are compared.
Results
Antibiotics consumption pattern changed with a decrease in total antibiotic consumption from 101.42 to 94.1 Defined Daily Dose/100 patients’ days after the clinical pharmacist participation, in addition to, a statistically significant rise ( = 0.001) in percentage of appropriateness of the prescribed antibiotic therapy from 72.1% to 86.3%. Time to control infection (days) was not statistically different ( = 0.825) in both periods. The average ICU days of stay was statistically significant longer ( = 0.046) during pharmacist attendance (4.42 ± 5.61) in comparison with period without pharmacist attendance (3.31 ± 3.66). The difference in ICU mortality rate was not statistically significance ( = 0.217). Cost per stay increased by 65% during pharmacist intervention period.
Conclusions
Antibiotic management with pharmacist participation as a part of multidisciplinary team with intensivist can promote rate of the appropriateness of the prescribed antibiotic therapy, lower utility of antibiotic consumption, but with a longer ICU stay, no mortality reduction, and higher expenses per stay.
Trial Registry
ClinicalTrials.gov: NCT04931914.

Keywords

Egyptian Journal of Anaesthesia
Volume 40, Issue 1
December 2024
Pages 292-299

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