Am J Infect Control. 2022 Feb 1:S0196-6553(22)00054-2. doi: 10.1016/j.ajic.2022.01.015. Online ahead of print.
BACKGROUND: A prospective audit with intervention and feedback (PAF) by pharmacists is important for the appropriate use of antimicrobials. Clinically, Escherichia coli (E. coli) bacteremia is a common condition, but only few researchers have examined the role of PAF in its appropriate use of antimicrobials.
METHODS: We started PAF by pharmacists in 2017 for all injectable antibiotics. This study included cases of E. coli bacteremia that resulted in hospitalization over a 4-year period from 2016 to 2019. Patients were grouped by year (Period 0-3), and clinical outcomes were examined.
RESULTS: The pharmacists had 12 and 54 suggestions in Periods 0 and 3, respectively. The most common suggestion was de-escalation. The median duration of antimicrobial use was 12 (interquartile range: 8-15) days in Periods 0-2. The duration of antimicrobial use was significantly reduced to 9 (7-12) days in Period 3. In Period 3, the duration of antimicrobial use was reduced by 29%, while anti-pseudomonal drug use was reduced by 42% compared with that in period 0. The 30-day mortality rates were not significantly different between the groups.
CONCLUSIONS: PAF by pharmacists promotes the appropriate use of antimicrobials in patients with E. coli bacteremia; it is important to continue the program for several years.