Effect of pharmacist interventions on antibiotic use in the general pediatric ward

Jiao Tian1, Meng-Meng Wang2, Xun Jiang3

  • 1Department of Pediatrics & Department of Pharmacy, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an, China/Guangzhou Women and Children's Medical Center, 9 Jinsui Road, Guangzhou, China.

Insights

Clinical pharmacists significantly improved antibiotic prescribing in a pediatric ward. Interventions reduced inappropriate antibiotic use, costs, and improved patient outcomes, demonstrating pharmacists

Area of Science:

  • Pharmacology
  • Pediatric Medicine
  • Hospital Pharmacy Practice

Background:

  • Antibiotic overuse and irrational prescribing are prevalent in Chinese hospitals.
  • Optimizing antibiotic use in pediatric wards is crucial for patient safety and economic efficiency.

Purpose of the Study:

  • To evaluate the impact of clinical pharmacist interventions on antibiotic utilization in a pediatric ward.
  • To assess the effects of these interventions on clinical appropriateness and economic outcomes.

Main Methods:

  • A pre-to-post intervention study design was employed in a Chinese tertiary hospital.
  • Data from 1408 pediatric patients (671 pre-intervention, 737 post-intervention) were analyzed.
  • Pharmacist-led interventions focused on promoting rational antibiotic use.

Main Results:

  • Significant reductions were observed in antibiotics used without indications (33.55% to 15.82%), inappropriate choice (24.79% to 16.58%), dose (8.55% to 4.34%), combination therapy (11.75% to 5.10%), and prolonged duration (14.53% to 10.46%).
  • Mean antibiotic costs and cost per patient-day decreased significantly.
  • The cost saving to pharmacist time ratio was 16.77:1.

Conclusions:

  • Clinical pharmacists play a vital role in optimizing antibiotic use in pediatric settings.
  • Interventions led to favorable clinical and economic outcomes, highlighting the value of pharmacist involvement.

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
110
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
134
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
109
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
90
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
109
Combined Effects of Drugs: Synergism01:27

Combined Effects of Drugs: Synergism

Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
5.9K