The impact of pharmacist early active consultation (PEAC) on multidrug resistance organism treatment outcomes: A prospective historically controlled study

Abstract

Background and aim: Infectious disease (ID) consultation can improve multidrug-resistant organism (MDRO) treatment outcomes. However, the impact of clinical pharmacists’ ID consultation on MDRO therapy, especially early initiation, has not been reported. In this study, we try to explore the impact of the pharmacist early active consultation (PEAC) on MDRO patient management.Methods: We conducted a prospective historical controlled study based on PEAC in MDRO patients. The retrospective control group was patients hospitalized 18 months before the PEAC initiation, and the prospective PEAC group was patients hospitalized 18 months after the PEAC initiation. Primary endpoint was 30-day all-cause mortality. Secondary outcomes were MDRO clinical outcome, duration of antibiotic use, length of stay, antibiotic consumption and antibiotic costs. Further subgroup analysis of secondary outcomes was performed by the condition at admission, MDRO pathogenicity and MDRO clinical outcome.Results: 188 MDRO patients were included. After adjusting for potential predictors, PEAC reduced the 30-day all-cause mortality by 70% (HR 0.30, 95% CI 0.09–0.96, p = 0.042). PEAC group had clinical improvement than control group (89.47% vs. 65.59%, p < 0.001), especially in patients with non-severe clinical conditions at admission (98.41% vs. 70.18%, p < 0.001). However, no significant differences were found between groups in length of stay, antibiotics consumption, and antibiotics costs.Conclusion: Early active pharmacy ID consultation can reduce 30-day all-cause mortality and improve clinical outcomes in MDRO patients.

Effectiveness Analysis of Clinical Pharmacists-Led Medication Therapy of Refined Management Mode:Antibiotics Administration

“…Clinical pharmacist intervention can reduce the rate of unreasonable drug application [19,20,21], shorten the length of hospital stay of patients, lower the incidence of adverse drug reactions, and improve the effect of anti-infection treatment. Daijing Dong et al [22] found the rational rate of prophylactic use of antibiotics in class I incisions was signi cantly improved, and the course of medication was obviously reduced before and after the intervention of clinical pharmacists.Meanwhile, other studies also pointed out [23,24] that the participation of clinical pharmacists in the consultation and individualized adjustment of medication regimens can ensure that patients receive more economic and effective treatment, and have a positive impact on reducing the inhospital mortality of patients with multi-drug resistant infection. Our research further a rmed the value of clinical pharmacists in the rational use of antibiotics.…”