Japanese Society for Infection Prevention and Control-Online Journal

Full Text of PDF (476K)
Article in Japanese

Management of Antimicrobial Adverse Effects by a Full-Time Pharmacist at an Antimicrobial Stewardship Team and Their Outcomes

Masahiro TAKADA¹⁾²⁾, Keitaro OMORI³⁾, Mika SHINGAI¹⁾, Kanami HOSHIKAWA²⁾ and Takeshi SUDO¹⁾⁴⁾
¹⁾Division of Infection Control and Prevention, National Hospital Organization Kure Medical Center, ²⁾Division of Pharmacy, National Hospital Organization Kure Medical Center, ³⁾Department of Infection Diseases, Hiroshima University Hospital, ⁴⁾Department of Surgery, National Hospital Organization Kure Medical Center

To evaluate how the involvement and outcomes of antibiotic-associated adverse drug events (ADEs) changed as a result of full-time pharmacists in the Antimicrobial Stewardship Team (AST), we investigated the "response to ADEs" as part of AST interventions. This single-center cohort study compared process and outcome measures between two periods: pre-introduction from April 2021 to August 2022 and post-introduction from September 2022 to January 2024 of full-time AST pharmacists, among hospitalized patients. The number of patients responding to ADEs in the AST intervention increased significantly from 1.9% (5/264 patients) in the pre-introduction group to 7.2% (67/936 patients) in the post-introduction group (p = 0.002). Grade 1 ADEs increased from 0 cases pre-introduction to 10 cases post-introduction. The variety of ADEs intervened increased from 3 to 18. The most frequent intervened ADEs were Clostridioides difficile infection 19% (14: 0 in pre-introduction, 14 in post-introduction), skin disorders 15% (11: 2 in pre-introduction, 9 in post-introduction), and eosinophilia 12% (9: 0 in pre-introduction, 9 in post-introduction). In terms of clinical outcomes, 87% of ADEs cases resulted in recovery (65: 5 in pre-introduction, 60 in post-introduction), and 90% were cured (53: 5 in pre-introduction, 48 in post-introduction), with no statistically significant differences in outcome rates between groups. Therefore, full-time employment of AST pharmacists is effective in increasing the number of patients responding to ADEs, as well as in detecting a variety of ADEs in mild cases, and in supporting the completion of treatment of infectious diseases.

Key words：antibiotic-associated adverse drug events, intervention, full-time pharmacist, outcome

e-mail: takada.masahiro.gu＠mail.hosp.go.jp

Received: February 20, 2025
Accepted: May 16, 2025

40 (4)：182─189,2025