Pharmacist recommendations for carbapenem de-escalation in urinary tract infection within an antimicrobial stewardship program

Sadyrbaeva-Dolgova, Svetlana; Aznarte-Padial, Pilar; Jiménez-Morales, Alberto; Expósito-Ruíz, Manuela; Calleja‐Hernández, Miguel Ángel; Hidalgo-Tenorio, Carmen

doi:10.1016/j.jiph.2019.09.014

Cited by 20 publications

(15 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These 23 studies were further reviewed, and five only were included in the meta-analysis; in the end, 14 studies with inappropriateness were included. [27][28][29][30][31][32][33][34][35][36][37][38][39][40] Therefore a total 32 studies were eventually included in the study; details of the study characteristics are provided in online supplemental table 1.…”

Section: Results and Findings General Characteristicsmentioning

confidence: 99%

Evaluation of inappropriate antibiotic prescribing and management through pharmacist-led antimicrobial stewardship programmes: a meta-analysis of evidence

et al. 2021

View full text Add to dashboard Cite

Purpose This meta-analysis aims to evaluate inappropriate antibiotic prescribing in the Gulf region and determine the effect of pharmacist-led antimicrobial stewardship (AMS) programmes on reducing inappropriateness. Method Articles were searched, analysed, and quality assessed through the risk of bias (ROB) quality assessment tool to select articles with a low level of bias. In step 1, 515 articles were searched, in step 2, 2360 articles were searched, and ultimately 32 articles were included by critical analysis. Statistical analysis used to determine risk ratio and standard mean differences were calculated using Review manager 5.4; 95% confidence intervals were calculated using the fixed-effect model. The I 2 statistic assessed heterogeneity. In statistical heterogeneity, subgroup and sensitivity analyses, a random effect model was performed. The α threshold was 0.05. The primary outcome was inappropriateness in antibiotic prescribing in the Gulf region and reduction of inappropriateness through AMS. Result Detailed review and analysis of 18 studies of inappropriate antibiotic prescribing in the Gulf region showed the risk of inappropriateness was 43 669/100 846=43.3% (pooled RR 1.31, 95% CI 1.30 to 1.32). Test with overall effect was 58.87; in the second step 28 AMS programmes led by pharmacists showed reduced inappropriateness in AMS with pharmacist versus pre-AMS without pharmacist (RR 0.36, 95% CI 0.32 to 0.39). Conclusion Inappropriate antibiotic prescribing in the Gulf region is alarming and needs to be addressed through pharmacist-led AMS programmes.

show abstract

Section: Results and Findings General Characteristicsmentioning

confidence: 99%

Evaluation of inappropriate antibiotic prescribing and management through pharmacist-led antimicrobial stewardship programmes: a meta-analysis of evidence

et al. 2021

View full text Add to dashboard Cite

show abstract

“…However, it did not decrease the readmission rate [ 25 ]. Readmission for UTI patients was assessed in a retrospective chart review comparing outcomes between two different periods, and this intervention proved to be effective in reducing readmission rates [ 26 ]. Staphylococcal bloodstream infection was investigated in one particular study through conducting unsolicited standardised form-based ASP and resulted in a reduction in the 30-day readmission rate.…”

Section: Discussionmentioning

confidence: 99%

Impact of Multidisciplinary Team Escalating Approach on Antibiotic Stewardship in the United Arab Emirates

et al. 2021

View full text Add to dashboard Cite

Antimicrobial stewardship programs (ASP) are an essential strategy to combat antimicrobial resistance. This study aimed to measure the impact of an ASP multidisciplinary team (MDT) escalating intervention on improvement of clinical, microbiological, and other measured outcomes in hospitalised adult patients from medical, intensive care, and burns units. The escalating intervention reviewed the patients’ cases in the intervention group through the clinical pharmacists in the wards and escalated complex cases to ID clinical pharmacist and ID physicians when needed, while only special cases required direct infectious disease (ID) physicians review. Both non-intervention and intervention groups were each followed up for six months. The study involved a total of 3000 patients, with 1340 (45%) representing the intervention group who received a total of 5669 interventions. In the intervention group, a significant reduction in length of hospital stay (p < 0.01), readmission (p < 0.01), and mortality rates (p < 0.01) was observed. Antibiotic use of the WHO AWaRe Reserve group decreased in the intervention group (relative rate change = 0.88). Intravenous to oral antibiotic ratio in the medical ward decreased from 4.8 to 4.1. The presented ASP MDT intervention, utilizing an escalating approach, successfully improved several clinical and other measured outcomes, demonstrating the significant contribution of clinical pharmacists atimproving antibiotic use and informing antimicrobial stewardship.

show abstract

“…Numerous developed countries, including the United States, United Kingdom, Australia, and Canada, have implemented AMS programs successfully ( Seo et al, 2016 ; Charani et al, 2017 ; DiDiodato and McAthur, 2017 ; Rautemaa-Richardson et al, 2018 ; Cipko et al, 2020 ); however, its implementation in developing countries is challenging ( Hayat et al, 2020 ). It has been proven that pharmacist-driven AMS is beneficial in reducing the duration of antimicrobial treatment, shortening hospital stays, lowering patient mortality, optimizing antimicrobials use, and limiting the emergence of multidrug-resistant organisms ( Li et al, 2017 ; Parente and Morton, 2018 ; Wang et al, 2019 ; Sadyrbaeva-Dolgova et al, 2020 ; Takito et al, 2020 ). Therefore, the increased involvement of hospital pharmacists with AMS deserves more in-depth implementation and broader promotion.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Stewardship Programs in Northwest China: A Cross-Sectional Survey of Perceptions, Involvement, and Perceived Barriers Among Hospital Pharmacists

Hayat

et al. 2021

Front. Pharmacol.

View full text Add to dashboard Cite

Background: Antimicrobial stewardship (AMS) is a key prevention strategy in addressing the global concern of increasing antimicrobial resistance (AMR). Pharmacists are one of the integral members of AMS hospital teams around the world. Toward reducing AMR, a major strategy in China is to improve the capacity and participation of pharmacists in the AMS framework. However, little is known about how hospital pharmacists perceive their position and participation in AMS work, and the barriers to this work in China, especially in the Northwest region.Methods: Region this work describes a cross-sectional, anonymous, online survey study. Hospital pharmacists from five provinces/autonomous regions in northwest China were invited to participate in June and July 2020. Participants completed the survey by using WeChat, a popular social application in China. We purposefully distributed the questionnaire link and QR code to hospital pharmacists through the hospital antimicrobial resistance surveillance network, hospital antimicrobial consumption surveillance network, provincial and city pharmaceutical associations, and hospital pharmacist WeChat groups.Results: Out of 1032 respondents, 93.1% believed that AMS programs promote the judicial prescribing of antimicrobials, 95.5% strongly agreed that AMS could reduce the widespread use of antimicrobials, and 92.3% believed that AMS could improve medical services. Pharmacists were most likely to be involved in AMS through reviewing prescriptions of antimicrobials, intervening in inappropriate prescriptions, and providing feedback on antimicrobial prescriptions and medical orders. Barriers to participating in AMS included workload (59.5% of respondents), ineffective communication between pharmacists and doctors (57.7%), and inadequate knowledge of AMS (47.0%). Differences in responses were found between the five surveyed provinces. A significant association was found between median involvement scores and gender, age, education, level of superiority, experience, and type of hospital (p < 0.05).Conclusion: Pharmacists perceived that AMS programs are important, but that their involvement in related activities is limited in all provinces. Further studies and strategies should consider how to overcome the identified barriers to optimize the participation of pharmacists in AMS programs.

show abstract

Pharmacist recommendations for carbapenem de-escalation in urinary tract infection within an antimicrobial stewardship program

Cited by 20 publications

References 33 publications

Evaluation of inappropriate antibiotic prescribing and management through pharmacist-led antimicrobial stewardship programmes: a meta-analysis of evidence

Evaluation of inappropriate antibiotic prescribing and management through pharmacist-led antimicrobial stewardship programmes: a meta-analysis of evidence

Impact of Multidisciplinary Team Escalating Approach on Antibiotic Stewardship in the United Arab Emirates

Antimicrobial Stewardship Programs in Northwest China: A Cross-Sectional Survey of Perceptions, Involvement, and Perceived Barriers Among Hospital Pharmacists

Contact Info

Product

Resources

About