ผลของการมีเภสัชกรร่วมในโปรแกรมการเปลี่ยนแปลงและชี้นำการใช้ยาต้านจุลชีพต่อความเหมาะสมในการสั่งใช้ยาต้าน จุลชีพ Effects of Pharmacist Participation in an Antimicrobial Stewardship Program on Appropriate Antibiotic Use

Abstract

Objective: To evaluate outcomes of pharmacist participation in anantimicrobial stewardship program (ASP) on improving appropriateantibiotic use and consumption. Method: The data were collected bymedical chart review in a retrospective cohort design. This study included380 prescriptions from 283 patients admitted to a medicine ward(Sawaslom-3 ward) of the King Chulalongkorn Memorial hospital fromJanuary to May 2013 of which the ASP using education approaches anddrug use evaluation forms with no pharmacist participation had beenimplemented. Data when pharmacist participation were collected fromJanuary to May 2014, of which pharmacists evaluated the prescriptions andfeedback the prescribers. Effects of pharmacist participation onappropriateness of antimicrobial prescribing and antibiotic consumptionwere determined in forms of defined daily dose/1,000 inhabitants(DDD/1000 inhabitants) of 3rd generation cephalosporins,betalactam/betalactamase inhibitors (BLBIs) and carbapenems. Results:ASP with pharmacist participation was associated with increasingprescribing appropriateness from 89.2% to 78.2% (P = 0.008).Inappropriate dosage was the most declining cause, from 6.7% to 2.5% (P= 0.047). The overall antibiotic consumption was slightly increased with nostatistical significance. Conclusion: Pharmacist participation in the ASPcould increase the appropriateness of antimicrobial prescribing especiallyinappropriate dosage, but not overall antibiotic consumption.Keywords: antimicrobial stewardship program, appropriate antibiotics use,pharmacist