Evaluation of treatment outcomes of patients with MRSA bacteremia following antimicrobial stewardship programs with pharmacist intervention

Ohashi, Kengo; Matsuoka, T.; Shinoda, Yasutaka; Fukami, Yasuyuki; Shindoh, Joe; Yagi, Tetsuya; Yoshimura, Tomoaki; Sugiyama, Tadashi

doi:10.1111/ijcp.13065

Cited by 21 publications

(21 citation statements)

References 27 publications

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“…In this study, we verified whether the ward pharmacists contribute to the active implementation of TDM in anti- MRSA agents using large health insurance claims database. The strength of this study was the provision of more generalized information compared with previous single-center studies [6][7][8][9]. To account for the confounding, we employed the propensity score method for comparison of the proportions of TDM implementation between the ward and non-ward pharmacy services [14].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…As described above, the effectiveness of pharmacist interventions in TDM have been reported previously [ 6 – 9 ]. However, almost all these studies were performed in a single center.…”

Section: Introductionmentioning

confidence: 91%

“…which covers anti-methicillin-resistant Staphylococcus aureus (MRSA) agents, antiepileptic agents, immunosuppressants, and arrhythmia agents [ 5 ]. Among them, anti-MRSA agents are widely subjected to TDM by pharmacists, and its usefulness has been previously reported [ 6 – 9 ]. For example, Komoto et al reported that pharmacist intervention of dose settings of vancomycin (VCM) was associated with maintaining a balance between the efficacy and safety of VCM therapy [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Association of the ward pharmacy service with active implementation of therapeutic drug monitoring for vancomycin and teicoplanin—an epidemiological surveillance study using Japanese large health insurance claims database

Imai

Momo

Kashiwagi

et al. 2020

J Pharm Health Care Sci

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Background Ward pharmacists are required for the active implementation of therapeutic drug monitoring (TDM). This epidemiological study verified whether Japanese ward pharmacists contribute to improving the TDM implementation proportions of anti-methicillin-resistant Staphylococcus aureus (MRSA) agents using the large health insurance claims database. Methods The patients who received intravenous anti-MRSA agents from April 2012 to March 2017 were enrolled. We defined ward pharmacy service as the “drug management and guidance fee” and/or “inpatient pharmaceutical services premium”. In addition, implementation of TDM was identified by “the specific drug treatment management fee”. We compared the proportions of TDM implementation for vancomycin (VCM), teicoplanin (TEIC), and arbekacin (ABK) in the ward and non-ward pharmacy service groups. To avoid confounding, the propensity score method was employed. Moreover, the clinical variables affecting TDM implementation in each anti-MRSA agent were analyzed by using a multiple logistic regression model. Results The following number of patients were included in the study: VCM (n = 2138), TEIC (n = 596), and ABK (n = 142). After propensity score matching, the proportions of TDM implementation for VCM and TEIC were higher in the ward pharmacy service group than in the non-ward pharmacy service group (VCM: 69.2% vs 60.3%, TEIC: 51.4% vs 34.7%), while no significant difference was observed for ABK (21.2% vs 23.1%). As independent clinical variables affecting TDM implementation for VCM and TEIC, several clinical variables, including ward pharmacy services, were extracted. In contrast, no clinical variables were extracted for ABK. Conclusions We found that the ward pharmacy service is associated with the active implementation of TDM for anti-MRSA agents, such as VCM and TEIC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…As described above, the effectiveness of pharmacist interventions in TDM have been reported previously [ 6 – 9 ]. However, almost all these studies were performed in a single center.…”

Section: Introductionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Association of the ward pharmacy service with active implementation of therapeutic drug monitoring for vancomycin and teicoplanin—an epidemiological surveillance study using Japanese large health insurance claims database

Imai

Momo

Kashiwagi

et al. 2020

J Pharm Health Care Sci

View full text Add to dashboard Cite

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“…Jokinen and others [27], as well, described that MRSA predicted worse outcomes than did methicillin-susceptible S. aureus. Ohashi et al [28] showed, however, that pharmacists' intervention in MRSA bacteremia improved the survival of sepsis patients. Additionally, Dolin et al [29] described that broad-spectrum antimicrobials would predispose patients to MRSA infection and thus compromise their prognosis.…”

Section: Discussionmentioning

confidence: 99%

Mortality related to drug-resistant organisms in surgical sepsis-3: an 8-year time trend study using sequential organ failure assessment scores

Yoshida

Tamura

Otani

et al. 2020

Eur J Clin Microbiol Infect Dis

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The difference in sequential organ failure assessment (SOFA) scores from the baseline to sepsis is a known predictor of sepsis-3 outcome, but the prognostic value of drug-resistant organisms for mortality is unexplained. We employed sepsis stewardship and herein report an observational study. Study subjects were patients admitted to the Departments of Surgery/Chest Surgery from 2011 through 2018 with a diagnosis of sepsis and a SOFA score of 2 or more. Our sepsis stewardship methods included antimicrobial and diagnostic stewardship and infection control. We determined the primary endpoint as in-hospital death and the secondary endpoint as the annual trend of the risk-adjusted mortality ratio (RAMR). For mortality, we performed logistic regression analysis based on SOFA score, age, sex, comorbid disease, and the presence of methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase inhibitor–producing bacteria. In a total of 457 patients, two factors were significant predictors for fatality, i.e., SOFA score of 9 or more with an odds ratio (OR) 4.921 and 95% confidence interval [95% CI] 1.968–12.302 (P = 0.001) and presence of MRSA with an OR 1.83 and 95% CI 1.003–3.338 (P = 0.049). RAMR showed a decrease during the study years (P < 0.05). Early detection of MRSA may help patients survive surgical sepsis-3. Thus, MRSA-oriented diagnosis may play a role in expediting treatment with anti-MRSA antimicrobials.

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Clinical outcome of pharmacist-led prospective audit with intervention and feedback after expansion from patients using specific antibiotics to those using whole injectable antibiotics

Ohashi

Matsuoka

Shinoda

et al. 2019

Eur J Clin Microbiol Infect Dis

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Evaluation of treatment outcomes of patients with MRSA bacteremia following antimicrobial stewardship programs with pharmacist intervention

Abstract: AS programs with pharmacist intervention improve mortality in patients with MRSA-B.

Cited by 21 publications

References 27 publications

Association of the ward pharmacy service with active implementation of therapeutic drug monitoring for vancomycin and teicoplanin—an epidemiological surveillance study using Japanese large health insurance claims database

Association of the ward pharmacy service with active implementation of therapeutic drug monitoring for vancomycin and teicoplanin—an epidemiological surveillance study using Japanese large health insurance claims database

Mortality related to drug-resistant organisms in surgical sepsis-3: an 8-year time trend study using sequential organ failure assessment scores

Clinical outcome of pharmacist-led prospective audit with intervention and feedback after expansion from patients using specific antibiotics to those using whole injectable antibiotics

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