Assessment of Antibiotic Use and Patient Outcomes After Pharmacist-Led Antimicrobial Stewardship Interventions at Nigist Eleni Mohammed Memorial Referral Hospital, Southern Ethiopia: A Quasi-Experimental Pre–Post Study

IF 2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice Pub Date : 2026-09-28 DOI:10.1155/ijcp/1924353

Mengistu Girma Tirore, Atalay Mulu Fentie, Zenebe Negash, Aschalewu Tsegaye Seyoum, Aster Bankifisa Yirga, Melaku Tesfaye Woldemariam, Bruke Berhanu Billoro

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引用次数: 0

Abstract

Background

Antimicrobial resistance is a major global public health threat, particularly in developing countries. Antimicrobial stewardship, particularly pharmacist-led stewardship, can play a vital role in combating antimicrobial resistance, and there are limited data on its impact in low-resource healthcare settings. This study aimed to assess the effect of pharmacist-led antimicrobial stewardship (AMS) on antimicrobial use and patient outcomes in Nigist Eleni Mohammed Memorial Referral Hospital (NEMMRH), Southern Ethiopia.

Method

A prospective quasi-experimental pre–post study was conducted from March 2023 to February 2024. In the pre-intervention phase, pharmacists audited antibiotic use without feedback, while during the intervention phase, pharmacists audited and provided feedback to the treating team (verbal and written). Our primary outcome variable was antimicrobial use, measured by duration of therapy and days of therapy per 1000 patient days. Secondary outcomes were length of hospital stay and in-hospital mortality. The two groups (preintervention and postintervention) were compared using Fisher’s exact or χ² tests for categorical variables, and an independent t-test for continuous variables. Statistical significance was declared at p value < 0.05.

Results

After the intervention period, a total of 128 (44.4%) patients’ cases involving antibiotic prescriptions requiring intervention were identified and intervened by the AMS team. Of these, 71 (24.7%) were recommended to discontinue, while 42 (14.6%) were advised to change the antibiotics. The most commonly prescribed antibiotics before and after the intervention phase were ceftriaxone 211 (73.3%) versus 175 (60.8%) and vancomycin 161 (55.9%) versus 91 (31.6%). Average duration of antibiotic treatment decreased significantly, from 10.02 ± 3.30 before intervention to 6.29 ± 2.58 during the intervention period (p < 0.001). Additionally, the days of therapy/1000 patient days declined from 660 ± 139.2 to 539 ± 114.6 (p = 0.01). The length of hospital stay was reduced from 14.17 ± 6.92 days in preintervention phase to 9.06 ± 3.97 days in the postintervention phase (p < 0.001). Furthermore, all-cause mortality decreased from 10.4% to 6.9%, although the difference was not statistically significant.

Conclusion

The findings indicated that pharmacist-facilitated AMS interventions were associated with lower inappropriate antibiotic utilization and length of hospital stay in our setting. Prospective implementation of such programs needs leadership commitment for sustainable benefits.

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埃塞俄比亚南部Nigist Eleni Mohammed纪念转诊医院药剂师主导的抗菌药物管理干预后抗生素使用和患者预后评估：一项准实验前后研究

抗微生物药物耐药性是一项重大的全球公共卫生威胁，特别是在发展中国家。抗菌素管理，特别是药剂师领导的管理，可以在对抗抗菌素耐药性方面发挥至关重要的作用，而且关于其在资源匮乏的卫生保健环境中的影响的数据有限。本研究旨在评估埃塞俄比亚南部Nigist Eleni Mohammed纪念转诊医院（NEMMRH）药剂师主导的抗菌药物管理（AMS）对抗菌药物使用和患者预后的影响。方法于2023年3月至2024年2月进行前瞻性准实验前后研究。在干预前阶段，药剂师审核抗生素使用情况，但没有反馈，而在干预阶段，药剂师审核并向治疗团队提供反馈（口头和书面）。我们的主要结局变量是抗菌药物的使用，通过治疗持续时间和每1000患者日的治疗天数来衡量。次要结局是住院时间和住院死亡率。对两组（干预前和干预后）进行比较，分类变量采用Fisher精确检验或χ2检验，连续变量采用独立t检验。p值为<； 0.05，有统计学意义。结果干预期结束后，AMS团队共识别并干预涉及抗生素处方的患者128例（44.4%）。其中，71例（24.7%）建议停用抗生素，42例（14.6%）建议更换抗生素。干预期前后最常用的抗生素是头孢曲松211（73.3%）对175（60.8%）和万古霉素161（55.9%）对91（31.6%）。抗生素治疗的平均持续时间显著减少，从干预前的10.02±3.30降至干预期间的6.29±2.58 （p < 0.001）。治疗天数从660±139.2天减少到539±114.6天（p = 0.01）。住院时间从干预前的14.17±6.92天减少到干预后的9.06±3.97天（p < 0.001）。此外，全因死亡率从10.4%下降到6.9%，尽管差异无统计学意义。结论药师辅助辅助医疗干预与减少不适当抗生素使用和住院时间有关。这些计划的前瞻性实施需要领导层的承诺，以获得可持续的利益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Clinical Practice 医学-医学：内科

CiteScore

5.30

自引率

0.00%

发文量

274

审稿时长

3-8 weeks

期刊介绍： IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.