The impact of the clinical pharmacists intervention on the appropriate antibiotic therapy of septic patients: a non-randomized controlled study

Abstract

Abstract Objective: Effective antimicrobial therapy is critical for the treatment of patients in the intensive care unit (ICU), especially septic patients. Early application of empirical therapy and subsequent de-escalation and appropriate dose selection are the three essential elements for optimal antimicrobial therapy. In this study, it was aimed to evaluate the impact of clinical pharmacists on antibiotic treatment of septic patients, and secondly, to determine drug-related problems in septic patients. Methods: This study was conducted at ICU of a university hospital. Septic patients who were provided medication review service by a clinical pharmacist were assigned to the intervention group. The control group consists of patients who were not provided medication review service. Intervention and control group were compared in terms of, time to de-escalation, appropriateness of antimicrobial dosing, and drug treatment costs. Results: 130 patients were included in the study to be divided equally between the intervention (prospective) and control groups (retrospective). 753 drug-related problems were detected in the intervention group. 644 intervention recommendations for these problems were presented to ICU team. Of these interventions, 298 (46.3%) were made for antimicrobial drugs. Statistically significant differences were found in comparison of time to de-escalation, appropriateness of the antimicrobial drug dosage, and antibiotic costs between the intervention and control groups (p£0.001). Conclusion: A clinical pharmacist on the sepsis management team may help ensure that septic patients receive the optimal antibiotic therapy and the reduction of antibiotic costs.