Pharmacist-driven antimicrobial stewardship program in a long-term care facility by assessment of appropriateness.

Autor: Cantudo-Cuenca MR; Pharmacy Department, Hospital Universitario Virgen de las Nieves, Granada, Spain. rosa_cantudo@hotmail.com.; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain. rosa_cantudo@hotmail.com.; Pharmacy Doctoral Programme, University of Granada, Granada, Spain. rosa_cantudo@hotmail.com., Jimenez-Morales A; Pharmacy Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain., la Plata JEM; Pharmacy Department, Hospital de Poniente, El Ejido, Spain.; Department of Biochemistry and Molecular Biology II, University of Granada, Granada, Spain.
Jazyk: angličtina
Zdroj: European geriatric medicine [Eur Geriatr Med] 2022 Dec; Vol. 13 (6), pp. 1357-1364. Date of Electronic Publication: 2022 Nov 14.
DOI: 10.1007/s41999-022-00715-4
Abstrakt: Methods: A prospective quasi-experimental study to implement an ASP in a LTCF. Antibiotic prescriptions for suspected infections initiated in any setting for LTCF residents were included. We assessed appropriateness and prospective audits and feedback of each inappropriate antimicrobial prescription were carried out. Associations of variables with appropriate antibiotic prescribing were estimated using logistic regression.
Results: A total of 416 antibiotic prescriptions were included. The mean consumption of antibiotics was reduced from 63.2 defined daily doses per 1000 residents days (DRD) in the preintervention period to 22.8 in the intervention period (- 63.8%), with a significant drop in fluoroquinolones (81.4%). Overall, 46.6% of antibiotic prescriptions were judged inappropriate, mainly because of a use not recommended in treatment guidelines (63.2%). Multivariable analysis showed that empirical therapy, some classes of antibiotics (cephalosporins, fluoroquinolones, fosfomycin calcium, macrolides) and prescription initiation in the emergency department were independent predictors of antimicrobial inappropriateness.
Conclusions: Pharmacist-led ASP in a LTCF has being effective in reducing consumption of antibiotics by improving appropriateness of treatment decisions. However, ASP should include interventions in the emergency department because of the high inappropriate use in this setting.
(© 2022. The Author(s), under exclusive licence to European Geriatric Medicine Society.)
Databáze: MEDLINE
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