Untapped potential: exploring clinical pharmacists as antibiotic stewardship ambassadors
Abstract Objective: To describe inpatient clinical pharmacists’ interventions on injectable antibiotics and assess their impact on prospective audit and feedback (PAF) by the antimicrobial stewardship program (ASP). Design: Retrospective cohort study. Setting: Freestanding, quaternary-care, pe...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X25000695/type/journal_article |
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| author | Esther Esadah Hayden T. Schwenk Laura L. Bio |
| author_facet | Esther Esadah Hayden T. Schwenk Laura L. Bio |
| author_sort | Esther Esadah |
| collection | DOAJ |
| description |
Abstract
Objective:
To describe inpatient clinical pharmacists’ interventions on injectable antibiotics and assess their impact on prospective audit and feedback (PAF) by the antimicrobial stewardship program (ASP).
Design:
Retrospective cohort study.
Setting:
Freestanding, quaternary-care, pediatric and obstetric hospital.
Methods:
We identified all clinical pharmacist interventions (iVents) documented on injectable antibiotics from November 1, 2020, through October 31, 2022. PAF performed on injectable antibiotics during the same timeframe was captured. We reported characteristics of clinical pharmacist iVents on injectable antibiotics. We also compared the incidence of PAF recommendations (PAFR) between PAF cases with prior iVent documentation for the same patient and antibiotic and those without preceding iVent documentation.
Results:
A total of 5,277 iVents were documented on injectable antibiotic orders. Cefazolin had the highest volume of iVents (13%). Antibiotic dose optimization was the most frequent iVent type (34%). A total of 5,152 PAF were documented by ASP pharmacists on injectable antibiotics during the study period, with 1,782 (34%) resulting in a PAFR. A total of 999 PAF (19%) had a prior iVent; 4,153 PAF did not. Comparing the two groups, the incidence of a PAFR was significantly higher in the PAF with prior iVent group compared to the PAF without prior iVent group (383/999, 38% vs 1,399/ 4,153, 34%; P = 0.006). Antibiotic discontinuation was the most common type of PAFR in both groups.
Conclusions:
Clinical pharmacists serve as ASP ambassadors, intervening on injectable antibiotic orders to improve prescribing. Future efforts to expand and incorporate clinical pharmacists in ASP initiatives are warranted.
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| format | Article |
| id | doaj-art-b5bc665ecec84ca9bb92eb237ff495e6 |
| institution | OA Journals |
| issn | 2732-494X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj-art-b5bc665ecec84ca9bb92eb237ff495e62025-08-20T02:20:25ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2025-01-01510.1017/ash.2025.69Untapped potential: exploring clinical pharmacists as antibiotic stewardship ambassadorsEsther Esadah0https://orcid.org/0009-0006-4826-9473Hayden T. Schwenk1Laura L. Bio2https://orcid.org/0000-0001-9520-6420Department of Pharmacy, Children’s National Hospital, Washington, DC, USADepartment of Pediatrics, Division of Infectious Diseases, Stanford School of Medicine, Stanford, CA, USADepartment of Pharmacy, Lucile Packard Children’s Hospital Stanford, Palo Alto, CA, USA Abstract Objective: To describe inpatient clinical pharmacists’ interventions on injectable antibiotics and assess their impact on prospective audit and feedback (PAF) by the antimicrobial stewardship program (ASP). Design: Retrospective cohort study. Setting: Freestanding, quaternary-care, pediatric and obstetric hospital. Methods: We identified all clinical pharmacist interventions (iVents) documented on injectable antibiotics from November 1, 2020, through October 31, 2022. PAF performed on injectable antibiotics during the same timeframe was captured. We reported characteristics of clinical pharmacist iVents on injectable antibiotics. We also compared the incidence of PAF recommendations (PAFR) between PAF cases with prior iVent documentation for the same patient and antibiotic and those without preceding iVent documentation. Results: A total of 5,277 iVents were documented on injectable antibiotic orders. Cefazolin had the highest volume of iVents (13%). Antibiotic dose optimization was the most frequent iVent type (34%). A total of 5,152 PAF were documented by ASP pharmacists on injectable antibiotics during the study period, with 1,782 (34%) resulting in a PAFR. A total of 999 PAF (19%) had a prior iVent; 4,153 PAF did not. Comparing the two groups, the incidence of a PAFR was significantly higher in the PAF with prior iVent group compared to the PAF without prior iVent group (383/999, 38% vs 1,399/ 4,153, 34%; P = 0.006). Antibiotic discontinuation was the most common type of PAFR in both groups. Conclusions: Clinical pharmacists serve as ASP ambassadors, intervening on injectable antibiotic orders to improve prescribing. Future efforts to expand and incorporate clinical pharmacists in ASP initiatives are warranted. https://www.cambridge.org/core/product/identifier/S2732494X25000695/type/journal_article |
| spellingShingle | Esther Esadah Hayden T. Schwenk Laura L. Bio Untapped potential: exploring clinical pharmacists as antibiotic stewardship ambassadors Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Untapped potential: exploring clinical pharmacists as antibiotic stewardship ambassadors |
| title_full | Untapped potential: exploring clinical pharmacists as antibiotic stewardship ambassadors |
| title_fullStr | Untapped potential: exploring clinical pharmacists as antibiotic stewardship ambassadors |
| title_full_unstemmed | Untapped potential: exploring clinical pharmacists as antibiotic stewardship ambassadors |
| title_short | Untapped potential: exploring clinical pharmacists as antibiotic stewardship ambassadors |
| title_sort | untapped potential exploring clinical pharmacists as antibiotic stewardship ambassadors |
| url | https://www.cambridge.org/core/product/identifier/S2732494X25000695/type/journal_article |
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