Intervention Evaluation for All Injectable Antimicrobial Use Cases Practiced by Full-time Pharmacist in the Antimicrobial Stewardship Team

Abstract

The antimicrobial stewardship team (AST) plays an important role in assisting with the treatment of infectious diseases. In August 2018, we started a program to dedicate a pharmacist to the AST and performed consultations focusing on patients before receiving intravenous antibiotics and all patients receiving intravenous antibiotics. In this study, we inves-tigated the impact of full-time pharmacist interventions on antimicrobial stewardship pre- (August 2017 – July 2018) and post- (August 2018 – July 2019) intervention. The total number of consultations with the full-time pharmacist increased significantly at 71 and 252 consultations pre- and post-intervention, respectively. There was no significant difference in the intervention, and a total of 69 (pass rate 85.5 ％ ) and 230 (83.5 ％ ) prescription improvement proposals were made pre- and post-intervention, respectively ( P = 0.852). There was no difference in 30-day mortality pre- and post-intervention. Additionally, as compared to the period from August 2017 to July 2018, that is, before the intervention, Antimicrobial Use Density (AUD) / Days of Therapy (DOT) for carbapenem antibiotics decreased from 0.73 to 0.58 during the intervention period ( P = 0.004). Based on these results, we suggest that the implementation of aggressive consultations and interventions by the full-time pharmacist is useful for promoting the appropriate treatment.