How Pharmacist-led Interventions Can Improve Discharge Antibiotic Use

When it comes to patient care and the use of antibiotics, antimicrobial stewardship programs are of vital importance. It has been demonstrated that when institutions utilize such programs they see a decrease in not only antibiotic use, but cost and associated infections as well.

However, inappropriate antibiotic use at hospital discharge has been worrying experts, as they often result in regimens that are too long, improperly dosed, or are too broad in spectrum.

Recently, investigators from the Moses H. Cone Memorial Hospital, in collaboration with the Fred Wilson School of Pharmacy at High Point University, conducted research which sought to evaluate discharge antibiotic prescribing and to see if a specific, pharmacist-led intervention could improve appropriate use.

Contagion sat down with Kushal Naik, PharmD, MBA, a pharmacy resident at Moses H. Cone, who presented the research at the 23rd Annual Making a Difference in Infectious Disease Meeting 2021 virtual sessions.

“The purpose of our research was to figure out a way how we can optimize patient discharge prescribing,” Naik said. “In the hospital, we have a lot of targeted efforts to improve antimicrobial stewardship, but many of these efforts are not carried out for discharge prescriptions.”

The quasi-experimental, pre-post study evaluated 162 patients who were 18 years of age or older and were discharged from the hospital with an oral antibiotic prescription. Two groups were included, a retrospective group evaluated a random sample of patients discharged in February of 2020 and a prospective group included patients discharged between January and April 2021.

Findings showed that of the 162 participants, 86 (53.1%) were discharged on inappropriate antimicrobial therapy, excessive duration being the principal driver. Of the pharmacist led interventions, 37 (66.1%) of 56 were accepted by providers in the intervention period.

“Pharmacists definitely have a large role to play in this field and in the whole sphere of antimicrobial stewardship in general,” Naik said. “Pharmacists, as well as our physician colleagues, are pretty up to date with our guide line recommendations and a pharmacist led intervention like this can continue to foster those guideline directed recommendations to be implemented in all of our patients.”