Impact of medical and pharmaceutical interventions on anti-infective prescriptions: an observational study

Eur J Clin Microbiol Infect Dis. 2022 Jul;41(7):1077-1086. doi: 10.1007/s10096-022-04465-w. Epub 2022 Jun 25.

Abstract

Appropriate prescribing of anti-infectives is a public health challenge. In our hospital, clinical microbiologists (clinical microbiology mobile unit, UMMc) and clinical pharmacists (clinical pharmacy, PHAc) carry out interventions on anti-infective prescriptions to improve practices. Our main objective was to evaluate the acceptance of UMMc and PHAc interventions on anti-infective prescriptions by quantifying the rate of prescription change 24 h after intervention. The secondary objective was to characterize the type of intervention and associate the rate of change for each. All prescriptions are computerized, and interventions traced via DxCare® software, which feeds a local data warehouse (HEGP-CDW). This descriptive, retrospective, single-center, uncontrolled study was conducted from January 2015 to December 2018. The data were extracted over this period from the data warehouse and analyzed using R software. UMMc interventions were accepted 72.2% of the time and PHA interventions 87.3%. The types of interventions found were mostly dose adjustments (61.1% for the UMMc and 54.2% for the PHAc) and proposals to change or stop a drug. Interventions have an impact on anti-infective prescriptions and are generally followed by clinicians. For the category "discontinuation of a molecule", almost half of the advice from the UMMc was refused. The collaboration between the UMMc and PHAc should be reinforced to improve acceptance.

Keywords: Anti-infective use; Antimicrobial stewardship; Appropriate prescribing; Infectious disease team; Pharmaceutical interventions.

Publication types

  • Observational Study

MeSH terms

  • Anti-Infective Agents* / therapeutic use
  • Drug Prescriptions
  • Humans
  • Pharmaceutical Preparations
  • Pharmacy*
  • Prescriptions
  • Retrospective Studies

Substances

  • Anti-Infective Agents
  • Pharmaceutical Preparations