Clinical Evaluation of Pharmacist Interventions in Patients Treated with Anti-methicillin-Resistant <i>Staphylococcus aureus</i> Agents in a Hematological Ward

Abstract

The therapeutic effects of anti-methicillin-resistant Staphylococcus aureus (MRSA) agents, vancomycin (VCM), teicoplanin (TEIC), and arbekacin (ABK), depend on their concentrations in blood. Therefore, therapeutic drug monitoring (TDM) is important when these antibiotics are used. In the hematological ward at Tokushima University Hospital, pharmacists have ordered the measurement of blood VCM, TEIC, and ABK concentrations to promote the use of TDM in accordance with an agreed protocol since 2013. Moreover, the infection control team includes several medical disciplines and has advised on the optimal treatment using VCM, TEIC, and ABK since 2013. This study aimed to investigate the clinical effectiveness of these pharmacist interventions. We retrospectively studied 145 cases in which patients were treated with VCM, TEIC, or ABK between January 2012 and December 2013 in the hematological ward at Tokushima University Hospital. The patients were divided into a control group (71 cases) and an intervention group (74 cases), and their clinical outcomes were compared. The rate of achievement of effective drug concentrations significantly increased in the intervention group (74%), compared to the rate in the control group (55%). Moreover, univariate and multivariate Cox proportional hazard regression revealed that pharmacist intervention and appropriate concentrations of anti-MRSA agents were independent factors associated with reduced hospitalization periods in patients with lymphoma. Our study revealed that proactive pharmacist intervention may improve the therapeutic effect of anti-MRSA agents in hematology ward patients.

Enhancing pharmacists’ role in developing countries to overcome the challenge of antimicrobial resistance: a narrative review

“…Studies showing positive impacts are from both developing [ 9 , 33 – 35 ] and developed [ 10 , 36 – 42 ] nations. These studies also demonstrate that pharmacists can improve appropriate antibiotic use in hospital [ 9 , 33 – 37 , 39 – 41 ] and community [ 10 , 38 , 42 ] settings.…”

“…These studies also demonstrate that pharmacists can improve appropriate antibiotic use in hospital [ 9 , 33 – 37 , 39 – 41 ] and community [ 10 , 38 , 42 ] settings.…”

Development and pharmacist‐mediated use of tools for monitoring atypical antipsychotic‐induced side effects related to blood glucose levels

“…Pharmacists actively intervene in the monitoring of side effects, and early avoidance of serious adverse reactions may shorten hospital stay . However, in this study, the intervention did not shorten hospital stay.…”

The Effectiveness of Clinical Pharmacist-Led Consultation in the Treatment of Infectious Diseases: A Prospective, Multicenter, Cohort Study

“…The crucial role of pharmacists in rational use of antimicrobial agents has been acknowledged in the healthcare systems of numerous countries (Northey et al, 2015;Waters, 2015;Zhou et al, 2015;Brink et al, 2016;Ellis et al, 2016;Okada et al, 2016). However, the value of CPC in ID treatment is still underestimated in China, and the lack of support from hospital administrators is the most common barrier to implementing CPC.…”