Clinical Impact of a Pharmacist-Driven Prospective Audit with Intervention and Feedback on the Treatment of Patients with Bloodstream Infection

Evidence for the utility of pharmacist-driven antimicrobial stewardship programs remains limited. This study aimed to evaluate the usefulness of our institutional pharmacist-driven prospective audit with intervention and feedback (PAF) on the treatment of patients with bloodstream infections (BSIs)....
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Autor*in:	Naoto Okada [verfasserIn] Momoyo Azuma [verfasserIn] Kaito Tsujinaka [verfasserIn] Akane Abe [verfasserIn] Mari Takahashi [verfasserIn] Yumiko Yano [verfasserIn] Masami Sato [verfasserIn] Takahiro Shibata [verfasserIn] Mitsuhiro Goda [verfasserIn] Keisuke Ishizawa [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	antimicrobial stewardship pharmacist prospective audit with intervention and feedback bloodstream infection

Übergeordnetes Werk:	In: Antibiotics - MDPI AG, 2013, 11(2022), 9, p 1144
Übergeordnetes Werk:	volume:11 ; year:2022 ; number:9, p 1144

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3390/antibiotics11091144

Katalog-ID:	DOAJ087039729

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spelling	10.3390/antibiotics11091144 doi (DE-627)DOAJ087039729 (DE-599)DOAJd6fe336fef3d4aa6a83c42ea180649a0 DE-627 ger DE-627 rakwb eng RM1-950 Naoto Okada verfasserin aut Clinical Impact of a Pharmacist-Driven Prospective Audit with Intervention and Feedback on the Treatment of Patients with Bloodstream Infection 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Evidence for the utility of pharmacist-driven antimicrobial stewardship programs remains limited. This study aimed to evaluate the usefulness of our institutional pharmacist-driven prospective audit with intervention and feedback (PAF) on the treatment of patients with bloodstream infections (BSIs). The effect of pharmacist-driven PAF was estimated using an interrupted time series analysis with a quasi-experimental design. The proportion of de-escalation during BSI treatment increased by 44% after the implementation of pharmacist-driven PAF (95% CI: 30–58, <i<p</i< < 0.01). The number of days of therapy decreased by 16 per 100 patient days for carbapenem (95% CI: −28 to −3.5, <i<p</i< = 0.012) and by 15 per 100 patient days for tazobactam/piperacillin (95% CI: −26 to −4.9, <i<p</i< < 0.01). Moreover, the proportion of inappropriate treatment in empirical and definitive therapy was significantly reduced after the implementation of pharmacist-driven PAF. Although 30-day mortality did not change, compliance with evidenced-based bundles in the BSI of <i<Staphylococcus aureus</i< significantly increased (<i<p</i< < 0.01). In conclusion, our pharmacist-driven PAF increased the proportion of de-escalation and decreased the use of broad-spectrum antibiotics, as well as the proportion of inappropriate treatment in patients with BSI. This indicates that pharmacist-driven PAF is useful in improving the quality of antimicrobial treatment and reducing broad-spectrum antimicrobial use in the management of patients with BSI. antimicrobial stewardship pharmacist prospective audit with intervention and feedback bloodstream infection Therapeutics. Pharmacology Momoyo Azuma verfasserin aut Kaito Tsujinaka verfasserin aut Akane Abe verfasserin aut Mari Takahashi verfasserin aut Yumiko Yano verfasserin aut Masami Sato verfasserin aut Takahiro Shibata verfasserin aut Mitsuhiro Goda verfasserin aut Keisuke Ishizawa verfasserin aut In Antibiotics MDPI AG, 2013 11(2022), 9, p 1144 (DE-627)726120596 (DE-600)2681345-2 20796382 nnns volume:11 year:2022 number:9, p 1144 https://doi.org/10.3390/antibiotics11091144 kostenfrei https://doaj.org/article/d6fe336fef3d4aa6a83c42ea180649a0 kostenfrei https://www.mdpi.com/2079-6382/11/9/1144 kostenfrei https://doaj.org/toc/2079-6382 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 11 2022 9, p 1144
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allfieldsSound	10.3390/antibiotics11091144 doi (DE-627)DOAJ087039729 (DE-599)DOAJd6fe336fef3d4aa6a83c42ea180649a0 DE-627 ger DE-627 rakwb eng RM1-950 Naoto Okada verfasserin aut Clinical Impact of a Pharmacist-Driven Prospective Audit with Intervention and Feedback on the Treatment of Patients with Bloodstream Infection 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Evidence for the utility of pharmacist-driven antimicrobial stewardship programs remains limited. This study aimed to evaluate the usefulness of our institutional pharmacist-driven prospective audit with intervention and feedback (PAF) on the treatment of patients with bloodstream infections (BSIs). The effect of pharmacist-driven PAF was estimated using an interrupted time series analysis with a quasi-experimental design. The proportion of de-escalation during BSI treatment increased by 44% after the implementation of pharmacist-driven PAF (95% CI: 30–58, <i<p</i< < 0.01). The number of days of therapy decreased by 16 per 100 patient days for carbapenem (95% CI: −28 to −3.5, <i<p</i< = 0.012) and by 15 per 100 patient days for tazobactam/piperacillin (95% CI: −26 to −4.9, <i<p</i< < 0.01). Moreover, the proportion of inappropriate treatment in empirical and definitive therapy was significantly reduced after the implementation of pharmacist-driven PAF. Although 30-day mortality did not change, compliance with evidenced-based bundles in the BSI of <i<Staphylococcus aureus</i< significantly increased (<i<p</i< < 0.01). In conclusion, our pharmacist-driven PAF increased the proportion of de-escalation and decreased the use of broad-spectrum antibiotics, as well as the proportion of inappropriate treatment in patients with BSI. This indicates that pharmacist-driven PAF is useful in improving the quality of antimicrobial treatment and reducing broad-spectrum antimicrobial use in the management of patients with BSI. antimicrobial stewardship pharmacist prospective audit with intervention and feedback bloodstream infection Therapeutics. Pharmacology Momoyo Azuma verfasserin aut Kaito Tsujinaka verfasserin aut Akane Abe verfasserin aut Mari Takahashi verfasserin aut Yumiko Yano verfasserin aut Masami Sato verfasserin aut Takahiro Shibata verfasserin aut Mitsuhiro Goda verfasserin aut Keisuke Ishizawa verfasserin aut In Antibiotics MDPI AG, 2013 11(2022), 9, p 1144 (DE-627)726120596 (DE-600)2681345-2 20796382 nnns volume:11 year:2022 number:9, p 1144 https://doi.org/10.3390/antibiotics11091144 kostenfrei https://doaj.org/article/d6fe336fef3d4aa6a83c42ea180649a0 kostenfrei https://www.mdpi.com/2079-6382/11/9/1144 kostenfrei https://doaj.org/toc/2079-6382 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 11 2022 9, p 1144
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callnumber-first	R - Medicine
author	Naoto Okada
spellingShingle	Naoto Okada misc RM1-950 misc antimicrobial stewardship misc pharmacist misc prospective audit with intervention and feedback misc bloodstream infection misc Therapeutics. Pharmacology Clinical Impact of a Pharmacist-Driven Prospective Audit with Intervention and Feedback on the Treatment of Patients with Bloodstream Infection
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topic_title	RM1-950 Clinical Impact of a Pharmacist-Driven Prospective Audit with Intervention and Feedback on the Treatment of Patients with Bloodstream Infection antimicrobial stewardship pharmacist prospective audit with intervention and feedback bloodstream infection
topic	misc RM1-950 misc antimicrobial stewardship misc pharmacist misc prospective audit with intervention and feedback misc bloodstream infection misc Therapeutics. Pharmacology
topic_unstemmed	misc RM1-950 misc antimicrobial stewardship misc pharmacist misc prospective audit with intervention and feedback misc bloodstream infection misc Therapeutics. Pharmacology
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title	Clinical Impact of a Pharmacist-Driven Prospective Audit with Intervention and Feedback on the Treatment of Patients with Bloodstream Infection
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title_full	Clinical Impact of a Pharmacist-Driven Prospective Audit with Intervention and Feedback on the Treatment of Patients with Bloodstream Infection
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title_sort	clinical impact of a pharmacist-driven prospective audit with intervention and feedback on the treatment of patients with bloodstream infection
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title_auth	Clinical Impact of a Pharmacist-Driven Prospective Audit with Intervention and Feedback on the Treatment of Patients with Bloodstream Infection
abstract	Evidence for the utility of pharmacist-driven antimicrobial stewardship programs remains limited. This study aimed to evaluate the usefulness of our institutional pharmacist-driven prospective audit with intervention and feedback (PAF) on the treatment of patients with bloodstream infections (BSIs). The effect of pharmacist-driven PAF was estimated using an interrupted time series analysis with a quasi-experimental design. The proportion of de-escalation during BSI treatment increased by 44% after the implementation of pharmacist-driven PAF (95% CI: 30–58, <i<p</i< < 0.01). The number of days of therapy decreased by 16 per 100 patient days for carbapenem (95% CI: −28 to −3.5, <i<p</i< = 0.012) and by 15 per 100 patient days for tazobactam/piperacillin (95% CI: −26 to −4.9, <i<p</i< < 0.01). Moreover, the proportion of inappropriate treatment in empirical and definitive therapy was significantly reduced after the implementation of pharmacist-driven PAF. Although 30-day mortality did not change, compliance with evidenced-based bundles in the BSI of <i<Staphylococcus aureus</i< significantly increased (<i<p</i< < 0.01). In conclusion, our pharmacist-driven PAF increased the proportion of de-escalation and decreased the use of broad-spectrum antibiotics, as well as the proportion of inappropriate treatment in patients with BSI. This indicates that pharmacist-driven PAF is useful in improving the quality of antimicrobial treatment and reducing broad-spectrum antimicrobial use in the management of patients with BSI.
abstractGer	Evidence for the utility of pharmacist-driven antimicrobial stewardship programs remains limited. This study aimed to evaluate the usefulness of our institutional pharmacist-driven prospective audit with intervention and feedback (PAF) on the treatment of patients with bloodstream infections (BSIs). The effect of pharmacist-driven PAF was estimated using an interrupted time series analysis with a quasi-experimental design. The proportion of de-escalation during BSI treatment increased by 44% after the implementation of pharmacist-driven PAF (95% CI: 30–58, <i<p</i< < 0.01). The number of days of therapy decreased by 16 per 100 patient days for carbapenem (95% CI: −28 to −3.5, <i<p</i< = 0.012) and by 15 per 100 patient days for tazobactam/piperacillin (95% CI: −26 to −4.9, <i<p</i< < 0.01). Moreover, the proportion of inappropriate treatment in empirical and definitive therapy was significantly reduced after the implementation of pharmacist-driven PAF. Although 30-day mortality did not change, compliance with evidenced-based bundles in the BSI of <i<Staphylococcus aureus</i< significantly increased (<i<p</i< < 0.01). In conclusion, our pharmacist-driven PAF increased the proportion of de-escalation and decreased the use of broad-spectrum antibiotics, as well as the proportion of inappropriate treatment in patients with BSI. This indicates that pharmacist-driven PAF is useful in improving the quality of antimicrobial treatment and reducing broad-spectrum antimicrobial use in the management of patients with BSI.
abstract_unstemmed	Evidence for the utility of pharmacist-driven antimicrobial stewardship programs remains limited. This study aimed to evaluate the usefulness of our institutional pharmacist-driven prospective audit with intervention and feedback (PAF) on the treatment of patients with bloodstream infections (BSIs). The effect of pharmacist-driven PAF was estimated using an interrupted time series analysis with a quasi-experimental design. The proportion of de-escalation during BSI treatment increased by 44% after the implementation of pharmacist-driven PAF (95% CI: 30–58, <i<p</i< < 0.01). The number of days of therapy decreased by 16 per 100 patient days for carbapenem (95% CI: −28 to −3.5, <i<p</i< = 0.012) and by 15 per 100 patient days for tazobactam/piperacillin (95% CI: −26 to −4.9, <i<p</i< < 0.01). Moreover, the proportion of inappropriate treatment in empirical and definitive therapy was significantly reduced after the implementation of pharmacist-driven PAF. Although 30-day mortality did not change, compliance with evidenced-based bundles in the BSI of <i<Staphylococcus aureus</i< significantly increased (<i<p</i< < 0.01). In conclusion, our pharmacist-driven PAF increased the proportion of de-escalation and decreased the use of broad-spectrum antibiotics, as well as the proportion of inappropriate treatment in patients with BSI. This indicates that pharmacist-driven PAF is useful in improving the quality of antimicrobial treatment and reducing broad-spectrum antimicrobial use in the management of patients with BSI.
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title_short	Clinical Impact of a Pharmacist-Driven Prospective Audit with Intervention and Feedback on the Treatment of Patients with Bloodstream Infection
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Clinical Impact of a Pharmacist-Driven Prospective Audit with Intervention and Feedback on the Treatment of Patients with Bloodstream Infection

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