The Role of Clinical Pharmacists in Antimicrobial Stewardship Programs (ASPs): A Systematic Review.

Autor:	Dighriri IM; Department of Pharmacy, King Abdulaziz Specialist Hospital, Taif, SAU., Alnomci BA; Faculty of Pharmacy, Qassim University, Qassim, SAU., Aljahdali MM; Faculty of Pharmacy, Batterjee Medical College, Jeddah, SAU., Althagafi HS; Faculty of Pharmacy, Taif University, Taif, SAU., Almatrafi RM; Faculty of Pharmacy, Umm Al-Qura University, Makkah, SAU., Altwairqi WG; Faculty of Pharmacy, Taif University, Taif, SAU., Almagati AA; Faculty of Pharmacy, King Abdulaziz University, Jeddah, SAU., Shunaymir AM; Department of Pharmacy, Makkah Healthcare Cluster, Makkah, SAU., Haidarah GA; Faculty of Pharmacy, Princess Nourah University, Riyadh, SAU., Alanzi MH; Department of Emergency Pharmacy, Dr. Sulaiman Al Habib Hospital, Riyadh, SAU., Hadadi AA; Department of Pharmacy, King Fahad Specialist Hospital, Dammam, SAU., Suwaydi HM; Faculty of Pharmacy, Jazan University, Jazan, SAU., Aqdi MJ; Faculty of Pharmacy, Jazan University, Jazan, SAU., Alharthi HN; Department of Forensic Center, Forensic Medical Services Center, Al Baha, SAU., Alshahrani AF; Department of Pharmacy, Armed Forces Hospital Southern Region, Abha, SAU.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Dec 08; Vol. 15 (12), pp. e50151. Date of Electronic Publication: 2023 Dec 08 (Print Publication: 2023).
DOI:	10.7759/cureus.50151
Abstrakt:	Antimicrobial resistance (AMR) is a major global health threat, increasing deaths and healthcare costs. Antimicrobial stewardship programs (ASPs) have been implemented to optimize antibiotic use and curb resistance. This systematic review aimed to summarize evidence on the role and impact of pharmacists in hospital ASPs. A comprehensive literature search was conducted across databases to identify relevant studies published from 2016 to 2023. Twenty-four studies met the inclusion criteria, comprising global observational and randomized clinical trials. Pharmacists performed various stewardship activities, including prospective audits, formulary management, de-escalation, guideline development, and education. Pharmacist-led interventions significantly improved antibiotic prescribing, reduced unnecessary antibiotic use, optimized therapy, and enhanced outcomes. Multiple studies found that pharmacist reviews decreased the time to optimal antibiotics and improved guideline compliance without affecting readmissions or revisits. De-escalation programs safely reduced antibiotic duration and length of stay. Acceptance rates for recommendations were high. Pharmacist stewardship curbed overall antibiotic use, costs, and duration across hospital departments, leading to savings. While most studies showed positive impacts, fewer detected significant changes in resistance or mortality over short periods. More research is needed, but current evidence demonstrates that pharmacists play critical roles in ASPs, leading to improved antibiotic use and patient outcomes. These findings support integrating pharmacists into stewardship activities, significantly extending programs to ambulatory settings. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Dighriri et al.)
Databáze:	MEDLINE
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