Clément Ourghanlian1, Nathanaël Lapidus2, Marie Antignac3, Christine Fernandez4, Catherine Dumartin5, Patrick Hindlet4. 1. AP-HP, Hôpital Henri Mondor, Pharmacie, F-94000, Créteil, France. Electronic address: clement.ourghanlian@aphp.fr. 2. Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F-75012, Paris, France; AP-HP, GH HUEP, Département de Santé Publique, F-75012, Paris, France. 3. AP-HP, GH HUEP, Pharmacie, F-75012, Paris, France. 4. Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F-75012, Paris, France; AP-HP, GH HUEP, Pharmacie, F-75012, Paris, France; Univ Paris-Sud, Faculté de Pharmacie, Département de Pharmacie Clinique, F-92296, Châtenay-Malabry, France. 5. Université de Bordeaux, INSERM 1219, F-33000, Bordeaux, France; CHU de Bordeaux, Centre d'appui pour la Prévention des Infections Associées aux Soins Nouvelle-Aquitaine, F-33000, Bordeaux, France.
Abstract
OBJECTIVES: Antimicrobial stewardship (AMS) teams around the world include pharmacists; however, their impact is relatively unknown. This study aimed to explore the relationship between pharmacists' actions and antibiotic consumption. METHODS: Hospital pharmacists involved in the French antibiotic consumption surveillance network (ATB-Raisin) were invited to participate in a retrospective observational multicentre study. Collected data were: the previous year's (2016) antibiotic consumption expressed in daily defined dose per 1000 patient-days; AMS measures, including pharmacist-specific actions; and use of a computerised prescription order entry (CPOE) system. Associations between antibiotic consumption and AMS measures were assessed by linear regression, after adjustment for hospital activities. RESULTS: Annual data for 2016 from 77 hospitals (7260000 bed-days in 24000 beds) were analysed. Pharmacists were involved in AMS programs in 73% of hospitals, and were the antibiotic advisor in 25%. Pharmaceutical review of prescriptions was organised in almost all hospitals (97%). The univariable analysis identified five measures associated with lower overall antibiotic consumption: CPOE use (if >80% of prescriptions or 100%), pharmaceutical review (if >80% of beds or 100%) and the antibiotic advisor being a pharmacist (P=0.04, P=0.004 and P=0.003, respectively). In the multivariable analysis, two explanatory variables were significantly and independently associated with a lower overall antibiotic consumption: the antibiotic advisor being a pharmacist and a pharmaceutical review covering all beds (-19.9% [-31.6%; -8.1%], P=0.002 and -18.3% [-34.0%; -2.6%], P=0.03, respectively). CONCLUSIONS: Antibiotic consumption was lower when the antibiotic advisor was a pharmacist and when the pharmaceutical team reviewed all prescriptions. These results highlight that actions initiated by pharmacists have a positive impact and should be supported.
OBJECTIVES: Antimicrobial stewardship (AMS) teams around the world include pharmacists; however, their impact is relatively unknown. This study aimed to explore the relationship between pharmacists' actions and antibiotic consumption. METHODS: Hospital pharmacists involved in the French antibiotic consumption surveillance network (ATB-Raisin) were invited to participate in a retrospective observational multicentre study. Collected data were: the previous year's (2016) antibiotic consumption expressed in daily defined dose per 1000 patient-days; AMS measures, including pharmacist-specific actions; and use of a computerised prescription order entry (CPOE) system. Associations between antibiotic consumption and AMS measures were assessed by linear regression, after adjustment for hospital activities. RESULTS: Annual data for 2016 from 77 hospitals (7260000 bed-days in 24000 beds) were analysed. Pharmacists were involved in AMS programs in 73% of hospitals, and were the antibiotic advisor in 25%. Pharmaceutical review of prescriptions was organised in almost all hospitals (97%). The univariable analysis identified five measures associated with lower overall antibiotic consumption: CPOE use (if >80% of prescriptions or 100%), pharmaceutical review (if >80% of beds or 100%) and the antibiotic advisor being a pharmacist (P=0.04, P=0.004 and P=0.003, respectively). In the multivariable analysis, two explanatory variables were significantly and independently associated with a lower overall antibiotic consumption: the antibiotic advisor being a pharmacist and a pharmaceutical review covering all beds (-19.9% [-31.6%; -8.1%], P=0.002 and -18.3% [-34.0%; -2.6%], P=0.03, respectively). CONCLUSIONS: Antibiotic consumption was lower when the antibiotic advisor was a pharmacist and when the pharmaceutical team reviewed all prescriptions. These results highlight that actions initiated by pharmacists have a positive impact and should be supported.
Authors: Emma Pinet; P Sabatier; M P Fernandez-Gerlinger; A S Jannot; J L Mainardi; B Sabatier; T Caruba Journal: Eur J Clin Microbiol Infect Dis Date: 2022-06-25 Impact factor: 3.267
Authors: Shana A B Burrowes; Mari-Lynn Drainoni; Maria Tjilos; Jorie M Butler; Laura J Damschroder; Matthew Bidwell Goetz; Karl Madaras-Kelly; Caitlin M Reardon; Matthew H Samore; Jincheng Shen; Edward Stenehjem; Yue Zhang; Tamar F Barlam Journal: Antimicrob Steward Healthc Epidemiol Date: 2021-11-12