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Table 2 Success stories of pharmacist intervention around the world in combating AMR from recently published articles

From: Enhancing pharmacists’ role in developing countries to overcome the challenge of antimicrobial resistance: a narrative review

Authors

Country

Setting

Objective

Study design

Type of intervention

Relevant outcomes

Brink et al., 2017 [97]

South Africa

Hospital

To implement an improvement model for existing resources, in order to achieve a reduction in surgical site infections (SSIs) across a heterogeneous group of 34 urban and rural South African hospitals

A pharmacist-driven, prospective audit and feedback strategy

Pharmacist included in the post-pharmacist intervention

pharmacists can effectively improve guideline compliance and sustainable patient

outcomes(P < 0.0001)

Ellis et al., 2016 [36]

USA

Hospital

To assess the impact of pharmacist intervention on appropriateness of antimicrobial prescribing on a geriatric unit

Pre and Post - pharmacist intervention

Pharmacist included in the post-pharmacist intervention

Post-intervention group had significantly less inappropriate doses for indication compared to the pre-intervention group (p = 0.02), pharmacist intervention group had less antibiotics prescribed for an inappropriate duration(p < 0.01), post intervention group had medications prescribed with appropriate dose, duration, and indication(p = 0.04)

Okada et al., 2016 [37]

Japan

Hospital

To investigate the clinical effectiveness of the pharmacist interventions on antibiotic use

Retrospective study design

Pharmacist included in the intervention group

Effective drug concentrations significantly increased in the intervention group. Intervention (74%) and control (55%).

Northey et al., 2015 [38]

Australia

Community

To assess the effectiveness of involving community pharmacy staff in patient education about antibiotic resistance

Randomized control study

Those in the intervention group were provided with verbal education by pharmacists

Antibiotic knowledge increased after receiving verbal antibiotic education (p = 0.008)

Zhou et al., 2015 [34]

China

Hospital

To describe the impacts of pharmacist intervention on the use of antibiotics, particularly in urology clean operations

Pre and Post - pharmacist intervention

Pharmacist included in the post intervention group

Average antibiotic cost decreased, cost of antibiotics as a percentage of total drug cost decreased by 27. 7%; the rate of use of antibiotics decreased from 100% to 7.3%

Booth et al., 2013 [10]

UK

Community

To compare the care pathway of patients with UTI symptoms attending GP services with those receiving management, including trimethoprim supply under PGD, via community pharmacies

Prospective, cross-sectional, mixed methods

Pharmacies invited a purposive sample of female patients to participate

Antibiotic treatments for UTIs could be provided via community pharmacy to improve patient access to treatment which may also maintain antibiotic stewardship and reduce GP workload

Magedanz et al., 2012 [9]

Brazil

Hospital

To assess the impact of ASP, with and without the presence of a pharmacist, in a cardiology hospital in Brazil

Pre and Post pharmacist intervention

Pharmacist included in the post-pharmacist intervention

Adherence to recommendations was increased (64%), hospital antibiotic cost reduction (69%).

Yen et al., 2012 [39]

Taiwan

Hospital

A pharmacist-managed antibiotic intravenous to oral (i.v.-to-p.o.) conversion program has been incorporated to minimize unnecessary i.v. antibiotic usage

Retrospectively collected by chart review

Pharmacist included in the intervention group

Length of hospital stay was significantly decreased (p = 0.001)

Dunn et al., 2011 [40]

Ireland

Hospital

To assess the impact of the introduction of guidelines and criteria for switching to oral antimicrobials

prospective and of controlled before and after design

Pharmacist included in the intervention group

Duration of IV antimicrobial treatment reduced significantly in the study group post intervention, (P = 0.02) compared to the control group

Grill et al., 2011 [41]

Germany

Hospital

To assess the impact of pharmaceutical consulting on the quality of antimicrobial use in a surgical hospital department

Prospective controlled intervention study

Pharmacist included in the intervention group

Intervention reduced the length of antimicrobial courses (IG = 10 days, CG = 11 days, incidence rate ratio for i.v. versus o.p. = 0.88, 95% confidence interval 0.84 to 0.93) and shortened i.v. administration (IG = 8 days, CG = 10 days, hazard rate = 1.76 in favour of switch from i.v. to p.o., 95% confidence interval 1.23 to 2.52).

95% confidence interval 1.23 to 2.52

Shen et al., 2011 [35]

China

Hospital

To evaluate the impact of pharmacist interventions on antibiotic use in inpatients with respiratory tract infections in a tertiary hospital in China

Randomized control study

Pharmacist included in the intervention group, no pharmacist in the control group

Total costs of hospitalization in the intervention group was lower compared to the control group P < 0.001. Total cost of antibiotics in the intervention group was lower to the control group (P = 0.01). Patients required shorter length of hospital stay (P = 0.03)

Hersberger et al., 2009 [42]

Switzerland

Community

To examine prescribing patterns of antibiotics and symptomatic medications for ARTI in Swiss primary care and to monitor pharmacists’ interventions during the prescription-dispensing process

Cluster randomized trial

Pharmacist included in the intervention group

Most patients (80%) were treated only with symptomatic medications. Most frequently prescribed symptomatic ARTI medications were nasal decongestants (39%), cough suppressants (36%), and mucolytic (31%)

  1. ASP: Antimicrobial Stewardship Program, UTI Urinary Tract Infection, ARTI Acute Respiratory Tract Infection, IV Intravenous
  2. GP: General Physician, PGD: Prescribing guidelines