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Updated: Apr 23, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
[Pharmaceutical intervention in duration of antimicrobial treatment at hospital ambit]
M Morante1, C Matoses-Chirivella, F J Rodríguez-Lucena
1María Morante Hernández, Servicio de Farmacia, Hospital General Universitario de Elche, Camino de la Almazara, s/n, 03203, Elche (Alicante), Spain. maria.morante@uv.es.
Objective:
To estimate the acceptance of the pharmaceutical intervention in controlling duration of antimicrobial therapy and to evaluate their impact on optimizing the treatment.
Methods:
Prospective observational study for two years in a General University Hospital. For the patients record, we followed non critical adult patients with antibiotic treatment. When the duration of antimicrobial treatment not complied with established criteria for each antibiotic and pathology, there was a communication with the physician, at which is recommended to assess the need for continue treatment. The acceptance of pharmaceutical intervention was collected and afterwards we analyzed the impact of this work by antimicrobial consumption and incidence of Clostridium difficile.
Results:
. In 122 patients the pharmacist made a pharmaceutical intervention due to prolonged antibiotic treatment. The most prevalent antibiotics were β-lactams, specifically meropenem. The intravenous administration was more frequent. In 77 cases it was decided to recommend the suspension of treatment, we conducted an orally prospective intervention at 70.15 % and the rest of interventions were written. Acceptance was 65.95 % and 65.00%, respectively. During the study period, the DDD of the antimicrobials decreased by 8.89% and expenditure on antimicrobials one 40.12%. The incidence of C. difficile was stable.
Conclusions:
. In a hospital, a pharmaceutical counselling program on the duration of antimicrobial therapy is well accepted by the prescriber physician, but it must be improved. The route of information does not affect the degree of acceptance. These actions could involve a reduction of antimicrobial consumption.
Insights
Pharmacist interventions to shorten antimicrobial therapy duration were accepted by physicians, leading to reduced antimicrobial use. Further improvements are needed, but the program shows promise in optimizing antibiotic treatment and lowering healthcare costs.
Area of Science:
- Pharmacology
- Infectious Diseases
- Hospital Pharmacy
Background:
- Antimicrobial resistance necessitates optimizing antibiotic therapy duration.
- Prolonged antibiotic use increases risks and costs.
- Pharmaceutical interventions can improve antimicrobial stewardship.
Purpose of the Study:
- To assess physician acceptance of pharmacist recommendations on antimicrobial therapy duration.
- To evaluate the impact of these interventions on antimicrobial consumption and Clostridium difficile incidence.
Main Methods:
- Prospective observational study over two years in a university hospital.
- Interventions targeted adult patients with non-compliant antimicrobial treatment durations.
- Physicians were consulted to reassess the need for continued antibiotic therapy.
Main Results:
- Pharmacist interventions occurred in 122 patients, primarily for prolonged β-lactam use (meropenem).
- Physician acceptance of recommendations to suspend treatment was 65.95% for oral and 65.00% for written interventions.
- Antimicrobial consumption (DDD) decreased by 8.89%, and expenditure by 40.12%, with stable C. difficile incidence.
Conclusions:
- Pharmaceutical counseling on antimicrobial therapy duration is accepted by prescribers but requires enhancement.
- Information delivery method (oral vs. written) did not impact acceptance rates.
- These interventions can significantly reduce antimicrobial consumption and associated costs.
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