Impact of clinical pharmacist‐led interventions on switching from intravenous‐to‐oral antibiotics in patients with infectious diseases at a Vietnamese hospital

Abstract

AbstractObjectivesTo evaluate the impact of clinical pharmacist‐led interventions on the switch from intravenous (IV) to oral (PO) antibiotics among inpatients with infectious diseases.MethodsA before‐and‐after study was conducted among inpatients aged 18 or older who were diagnosed with infectious diseases and received IV antibiotics for at least 24 h at the Thong Nhat Hospital during the pre‐intervention (between January 2021 and June 2021) and intervention (between January 2022 and June 2022) periods. Information on patient characteristics, antibiotic usage, length of hospital stay and treatment outcomes was obtained from medical records. The interventions included introducing IV‐to‐PO switch guidelines to physicians and clinical pharmacists' feedback on eligible cases. The impact of the pharmacists' interventions was evaluated by comparing primary outcomes (switch rate and appropriateness of switching) and secondary outcomes (duration of IV therapy, length of hospital stay and treatment outcomes) between the two study periods.ResultsWe included 99 patients in the pre‐intervention and 80 patients in the intervention period. The proportion of patients who switched from IV‐to‐PO antibiotics increased from 44.4% in the pre‐intervention period to 67.8% in the intervention period (p = 0.008). The overall rate of appropriate conversion increased significantly from 43.8% to 67.5% (p = 0.043). There were no statistically significant differences between the two periods with respect to the median duration of IV therapy (9 days vs. 8 days), length of hospital stay (10 days vs. 9 days) and treatment outcomes. Logistic regression analysis showed that the interventions resulted in a higher switch rate, whereas age was negatively associated with the switching rate.ConclusionsThe implementation of clinical pharmacist‐led interventions was effective in promoting IV‐to‐PO antibiotic conversion.