Pharmacist-driven antimicrobial stewardship program in an institution without infectious diseases physician support

Area of Science:

• Health Services Research
• Infectious Diseases
• Pharmacology

Background:

• Antimicrobial stewardship programs (ASPs) are crucial for optimizing antibiotic use and combating resistance.
• Traditionally, infectious diseases (ID) physicians lead ASPs, often with multidisciplinary support.
• Limited resources may necessitate alternative ASP leadership models.

Purpose of the Study:

• To describe the outcomes of a pharmacist-led ASP implemented without dedicated ID physician oversight.
• To evaluate the impact of this model on antimicrobial utilization and associated costs.

Main Methods:

• A pharmacist-led ASP was implemented at a 325-bed hospital.
• The pharmacist conducted daily patient profile reviews and physician consultations.
• Support was provided by an infection prevention nurse, physician champions, and other hospital personnel.

Main Results:

• Over 33 months, 2,457 interventions were made with a 91.8% acceptance rate.
• Significant decreases were observed in the utilization of carbapenems, daptomycin, echinocandins, and levofloxacin.
• The average length of stay for community-acquired pneumonia decreased significantly (p=0.03).
• Annual cost savings of $355,000 were estimated two years post-implementation.

Conclusions:

• A pharmacist-led ASP can achieve substantial reductions in antimicrobial utilization.
• This model demonstrates significant cost savings even without infectious diseases physician support.
• Pharmacist-led stewardship is a viable and effective strategy for improving drug utilization.