Effect of pharmacist consultation on rational antimicrobial therapy

The incidence of rational decisions concerning antimicorbial therapy before and after the establishment of clinical pharmaceutical services in a hospital was compared. A protocol was designed to determine the rationality of physician orders for antimicrobial therapy. This ptocol was used to analyze retrospectively the medical records for patients admitted to a 30-bed surgical unit and a 30-bed medical unit during two months before and after clinical pharmaceutical services were initiated. The results showed that exposure to routine clinical pharmaceutical services appeared to improve prescribing rationality only of drugs used to treat infectious conditions. Since the study design had no control group, the causal effect of clinical pharmaceutical services on the rationality of antimicrobial therapy could not be determined; however, the use of an organized protocol in monitoring antimicrobial therapy allowed an assessment of the use and misuse of antimicrobials in hospitals.