Antimicrobial Stewardship Pharmacist-driven Prospective Audit and Feedback of All Intravenous Antibiotics in a Middle-sized Community Hospital
Yasuhiro SASAKI1)8), Akira KURISHIMA2), Misato AMANO1)8), Ayumi KANAMARU3)8), Akiko YAMAKUCHI4)8), Hirobumi TAKAYASU5)8), Yoshiro HADANO6) and Masataka YANO7)8) 1)Department of Pharmacy, Tama-Nanbu Chiiki Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation, 2)Department of Pharmacy, Japan Community Health Care Organization Tokyo Shinjuku Medical Center, 3)Department of Nursing, Tama-Nanbu Chiiki Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation, 4)Department of Microbiological Laboratory, Tama-Nanbu Chiiki Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation, 5)Department of Pediatrics, Tama-Nanbu Chiiki Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation, 6)Department of infection Control and Prevention, Tokyo Medical and Dental University Hospital, 7)Department of Urology, Tama-Nanbu Chiiki Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation, 8)Antimicrobial Stewardship Team, Tama-Nanbu Chiiki Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation
The guidelines recommended formulary restriction and pre-authorization and prospective audit and feedback. In Japan, there are some reports of intervention and feedback for all injectable antibiotics from large hospitals, but none from middle-sized hospitals. This study aimed to assess the impact of prospective audit and feedback for all injectable antibiotics of antimicrobial stewardship (AS) pharmacists in changes of antibiotic agents in middle-sized hospitals. The days of therapy per 1,000 patient-days (DOT/1000 pd) of all injectable antibiotics significantly decreased from 248.6 to 217.1 (12.7%) after intervention. Furthermore, DOT/1000 pd of anti-pseudomonas agents significantly decreased from 60.0 to 35.5 (40.8%). All antibiotic costs were reduced by about 50,000 yen (18.4%) monthly. A hospital policy to optimize antimicrobial prescription introduced by AS pharmacists decreased antibiotic consumption, especially wide-spectrum agents.
Key words:antimicrobial stewardship, middle-sized hospital, prospective audit and feedback
e-mail:
yasuhiro_sasaki1@tokyo-hmt.jp
Received: July 6, 2020 Accepted: November 30, 2020
36 (2):117─122,2021
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