Effect of critical care pharmacist on antibiotic medication optimizations, reduce drug costs but not increase mortality: A retrospective cohort study in the real world research

Abstract

Background We aims to investigate the roles of clinical pharmacist on optimizing the antibiotic pharmacotherapy regimens and achieved better clinical and economic outcomes in the critical care unit (ICU). Methods A retrospective cohort study in real world was undertaken from the year of 2016 to 2017 as the pharmacist pre-intervention period and 2018 to 2019 as the pharmacist intervention period in ICU. All interventions and consensus with clinicians were recorded. The outcomes of the patients’ mortality, microorganism detections, antibiotic utilities, length of ICU stay (LOS), costs of the antibiotics and the total drugs used were reviewed. Results Of 1436 patients were evaluated and 1252 recommendations were identified. The main points of the pharmacist interventions were medication regimen adjustments (52.32%) and drug withdrawal (22.60%). Before and after the pharmaceutical interventions, the AUD of all antimicrobials consumed decreased from 211.83 to174.02 (p = 0.000), the rate of antimicrobial utility decreased from 89.88–86.82% (p = 0.001), mortality reduced from 18.73–15.21% (p = 0.002), antibiotic charges were from ࿥8,644 ± 12,556 to ࿥5,587 ± 7,606 (p = 0.000) with 39% reduction. Conclusions The services provided by the clinical pharmacist with highly professional training could optimize the antibiotic therapy regimes, saved the drug costs and did not increase mortalities.