Effects of pharmaceutical counselling on antimicrobial use in surgical wards: intervention study with historical control group,

Authors


  • Parts of the manuscript were presented as posters at the 4th Annual Meeting of the German Society of Epidemiology, 16–19 September 2009, Münster, Germany, and at the 43rd ASHP Midyear Clinical Meeting 2008, Orlando, Florida, USA.
  • Authorship All persons designated as authors qualify for authorship.

E. Grill, Institute for Health and Rehabilitation Sciences, Ludwig Maximilians University, 81377 Munich, Germany. E-mail: eva.grill@med.uni-muenchen.de

ABSTRACT

Purpose

The objective of this study was to assess the impact of pharmaceutical consulting on the quality of antimicrobial use in a surgical hospital department in a prospective controlled intervention study.

Methods

Patients receiving pharmaceutical intervention (intervention group, IG, n = 317) were compared with a historical control group (control group, CG, n = 321). During the control period, antimicrobial use was monitored without intervention. During the subsequent intervention period, a clinical pharmacist reviewed the prescriptions and gave advice on medication.

Results

Intervention reduced the length of antimicrobial courses (IG = 10 days, CG = 11 days, incidence rate ratio for i.v. versus o.p. = 0.88, 95% confidence interval 0.84 to 0.93) and shortened i.v. administration (IG = 8 days, CG = 10 days, hazard rate = 1.76 in favour of switch from i.v. to p.o., 95% confidence interval 1.23 to 2.52). Intervention also helped to avoid useless combination therapy and reduced total costs for antimicrobials.

Conclusions

A clinical pharmacist who reviews prescriptions can promote an increase in efficiency, for example, by shortening the course of treatment. Counselling by ward-based clinical pharmacists was shown to be effective to streamline antimicrobial therapy in surgical units and to increase drug safety. Copyright © 2011 John Wiley & Sons, Ltd.

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