Pharmacist´s contribution on antimicrobial stewardship program: ambispective cohort study

Abstract

Background: Antimicrobial stewardship program (AMSP) promotes the rational use of the antimicrobial, ensuring that each patient receives the correct antibiotic, by the correct time and at the correct dose. Aim: To establish the association of the results of an AMSP led by a pharmaceutical chemist, in terms of antibiotic consumption, duration of treatment and costs in a tertiary healthcare setting. Method: Ambispective cohort study. In the exposed cohort, in the environment of a AMSP, a pharmacist with training in infectious diseases evaluated and intervened the indication, dosage, duration of treatment and bacterial spectrum of the antimicrobial. The no-exposed cohort corresponded to a retrospective population that was similar (paired) to the exposed cohort, but that did not receive an evaluation of its antimicrobial therapy. Result: 258 patients were identified in the exposed cohort and 247 in the cohort not exposed to the AMSP. Decrease in the consumption of antibiotics was observed (119,831 vs 137,678 DDD/100 patients-day, p<0.001) and a decrease in 34.1% of the costs associated with antibiotic therapy of the exposed cohort, in comparison with the cohort not exposed to the AMSP. Conclusion: AMSP led by a pharmacist have better outcomes in terms of consumption and lower costs associated with antibiotic therapy.