Evaluation of inappropriate antibiotic prescribing and management through pharmacist-led antimicrobial stewardship programmes: a meta-analysis of evidence
| Autor: | Syed Wasif Gillani, Shabaz Mohiuddin Gulam, Rana Kamran Mahmood, Maryam Jaber Mohamed Abdulla Alzaabi |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
drug misuse Pharmacist Pharmacists Antimicrobial Stewardship medicine Humans Antimicrobial stewardship hospital General Pharmacology Toxicology and Pharmaceutics drug monitoring business.industry Evidence-based medicine Random effects model Confidence interval Anti-Bacterial Agents pharmacy service Study heterogeneity Meta-analysis Family medicine Relative risk health services administration Systematic Review evidence-based medicine business |
| Zdroj: | European Journal of Hospital Pharmacy |
| ISSN: | 2047-9964 2047-9956 |
| DOI: | 10.1136/ejhpharm-2021-002914 |
| Popis: | Purpose This meta-analysis aims to evaluate inappropriate antibiotic prescribing in the Gulf region and determine the effect of pharmacist-led antimicrobial stewardship (AMS) programmes on reducing inappropriateness. Method Articles were searched, analysed, and quality assessed through the risk of bias (ROB) quality assessment tool to select articles with a low level of bias. In step 1, 515 articles were searched, in step 2, 2360 articles were searched, and ultimately 32 articles were included by critical analysis. Statistical analysis used to determine risk ratio and standard mean differences were calculated using Review manager 5.4; 95% confidence intervals were calculated using the fixed-effect model. The I2 statistic assessed heterogeneity. In statistical heterogeneity, subgroup and sensitivity analyses, a random effect model was performed. The α threshold was 0.05. The primary outcome was inappropriateness in antibiotic prescribing in the Gulf region and reduction of inappropriateness through AMS. Result Detailed review and analysis of 18 studies of inappropriate antibiotic prescribing in the Gulf region showed the risk of inappropriateness was 43 669/100 846=43.3% (pooled RR 1.31, 95% CI 1.30 to 1.32). Test with overall effect was 58.87; in the second step 28 AMS programmes led by pharmacists showed reduced inappropriateness in AMS with pharmacist versus pre-AMS without pharmacist (RR 0.36, 95% CI 0.32 to 0.39). Conclusion Inappropriate antibiotic prescribing in the Gulf region is alarming and needs to be addressed through pharmacist-led AMS programmes. |
| Databáze: | OpenAIRE |
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