scholarly journals The impact of pharmacist intervention on prophylactic antibiotics use in orthopedic surgery at a hospital in China

Medicine ◽  
2021 ◽  
Vol 100 (52) ◽  
pp. e28458
Author(s):  
Hong Zhou ◽  
Lihong Liu ◽  
Xiao Sun ◽  
Huaguang Wang ◽  
Xiaojia Yu ◽  
...  
2020 ◽  
Vol 10 (2) ◽  
pp. 25-41
Author(s):  
Thejaswini Karanth ◽  
Someswar Deb ◽  
Lal Ruatpuii Zadeng ◽  
Rajeswari Ramasamy ◽  
Teena Nazeem ◽  
...  

Objective to assess the impact of pharmacist assisted counselling in improving Parental Knowledge, Attitude and Practice [KAP] towards antibiotic use in children. A Prospective, Educational Interventional Study was conducted in 200 subjects, from the randomly chosen communities in Bangalore. The investigators did door to door visit. The primary demographics data of parents and their children were collected using standard Case Report Form (CRF), and the baseline towards antibiotic use in Children was obtained from parents using validated Questionnaire. In the presence of both parents, only one was supposed to answer the Questionnaire. Pharmacist assisted parent centred interventional counselling was provided with the help of Patient Information Leaflet1s (PIL). Follow-up and post interventional KAP assessment were done after two months from the baseline measurement. The changes in parental KAP towards antibiotics use in children were being assessed by comparing the Pretest and Posttest responses using statistical analysis. The knowledge of parents towards antibiotic use in children was medium to good in the baseline KAP assessment; however, in the majority of the participating parents it was not satisfactory in attitude and practice domains. A statistically significant improvement was seen in the KAP of parents towards antibiotic use in children after the pharmacist assisted interventional counselling. Thus, Investigators could bring excellent changes in the knowledge part; whereas the result for changes in the Attitude and Practice was good to medium respectively.


2000 ◽  
Vol 37 (7) ◽  
pp. 545-555 ◽  
Author(s):  
H. M. Bell ◽  
J. C. McElnay ◽  
C. M. Hughes ◽  
I. Gleadhill

2021 ◽  
pp. 106002802110447
Author(s):  
Haley M. Gonzales ◽  
James N. Fleming ◽  
Mulugeta Gebregziabher ◽  
Maria Aurora Posadas Salas ◽  
John W. McGillicuddy ◽  
...  

Background Medication safety issues have detrimental implications on long-term outcomes in the high-risk kidney transplant (KTX) population. Medication errors, adverse drug events, and medication nonadherence are important and modifiable mechanisms of graft loss. Objective To describe the frequency and types of interventions made during a pharmacist-led, mobile health–based intervention in KTX recipients and the impact on patient risk levels. Methods This was a secondary analysis of data collected during a 12-month, parallel-arm, 1:1 randomized clinical controlled trial including 136 KTX recipients. Participants were randomized to receive either usual care or supplemental, pharmacist-driven medication therapy monitoring and management using a smartphone-enabled app integrated with telemonitoring of blood pressure and glucose (when applicable) and risk-based televisits. The primary outcome was pharmacist intervention type. Secondary outcomes included frequency of interventions and changes in risk levels. Results A total of 68 patients were randomized to the intervention and included in this analysis. The mean age at baseline was 50.2 years; 51.5% of participants were male, and 58.8% were black. Primary pharmacist intervention types were medication reconciliation and patient education, followed by medication changes. Medication reconciliation remained high throughout the study period, whereas education and medication changes trended downward. From baseline to month 12, we observed an approximately 15% decrease in high-risk patients and a corresponding 15% increase in medium- or low-risk patients. Conclusion and Relevance A pharmacist-led mHealth intervention may enhance opportunities for pharmacological and nonpharmacological interventions and mitigate risk levels in KTX recipients.


Author(s):  
Azade Ebrahimzadeh ◽  
Mohammad Najafi ◽  
Bita Bijari ◽  
Ahmad Amouzeshi ◽  
Mohammad Reza Abedini ◽  
...  

Background and Objectives: Taking unnecessary or inappropriate prophylactic antibiotics can cause infections with re- sistant organisms. The present study aimed to investigate administration prophylactic antibiotics in surgery ward and its compliance with standard protocol in Imam Reza teaching hospital of Birjand, Iran. Materials and Methods: This descriptive-analytical study was performed to evaluate the pattern of prophylactic antibiotics on patients who underwent surgical operations from October to December 2019. A checklist including demographic informa- tion, type of prophylactic antibiotics, dose and duration of using drug, type of surgery, and compliance with standard protocol was used. The validity and reliability of the checklist were evaluated and confirmed prior to the study. All eligible patients were enrolled and the information of the prescribed drugs in the surgical wards was compared with the Schwartz’s principles of surgery as standard protocol. Results: Out of a total of 300 patients, 187 (62.3%) were male. Among the patients, 155 (51.7%) cases underwent general surgery, 119 (39.6%) cases orthopedic surgery, and 26 (8.7%) cases neurosurgery. The most popular prescribed antibiotics were cefazolin (170 cases) and ceftriaxone + metronidazole (67 cases). Furthermore, the maximum antibiotic administrations were two days (127 cases) and one day (93 cases). More importantly, 67.7% and 92.3% of the patients were in compliance with the standard protocol in terms of the type and time of administration, respectively. Conclusion: Our results showed that duration and route of administrating antibiotics were consistent with the standard pro- tocol, but the type of drugs and indication did not match.


1977 ◽  
Vol 70 (Supplement) ◽  
pp. 50-54 ◽  
Author(s):  
ALAN PAVEL ◽  
ROBERT L SMITH ◽  
ANTHONY BALLARD ◽  
IVAR J. LARSON

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Samra Bashir ◽  
Akash Syed

The role of pharmacist intervention as a cost-effective alternative to physician in disease management is increasingly been recognized. Studies have demonstrated that pharmaceutical care can improve drug therapy as well as patient satisfaction in chronic health conditions including cardiovascular diseases. This study is aimed to review and outline a comprehensive pharmaceutical care plan from the randomized controlled trials previously conducted to assess the impact of pharmacist-managed care on disease outcomes in hypertensive patients. Compared with usual care, the pharmaceutical intervention involved patient evaluation, patient education and counselling, medication review and management, patient monitoring and follow-up, and feedback to the primary physician as major strategies.


2021 ◽  
pp. 001857872110375
Author(s):  
Brandon J. Tritle ◽  
Robert Watteyne ◽  
Abby Hickman ◽  
Todd J. Vento ◽  
Bert K. Lopansri ◽  
...  

Background: Rapid diagnostic tests (RDTs) for bacteremia allow for early antimicrobial therapy modification based on organism and resistance gene identification. Studies suggest patient outcomes are optimized when infectious disease (ID)-trained antimicrobial stewardship personnel intervene on RDT results. However, data are limited regarding RDT implementation at small community hospitals, which often lack access to on-site ID clinicians. Methods: This study evaluated the impact of RDTs with and without real-time pharmacist intervention (RTPI) at a small community hospital with local pharmacist training and asynchronous support from a remote ID Telehealth pharmacist. Time to targeted therapy (TTT) in patients with bacteremia was compared retrospectively across 3 different time periods: a control without RDT, RDT-only, and RDT with RTPI. Results: Median TTT was significantly faster in both the RDT with RTPI and RDT-only groups compared with the control group (2 vs 25 vs 51 hours respectively; P < .001). TTT was numerically faster for RDT with RTPI compared with RDT-only but did not reach statistical significance ( P = .078). Median time to any de-escalation was significantly shorter for RDT with RTPI compared with both RDT-only (14 vs 33 hours; P = .012) and the control group (14 vs 45 hours; P < .001). Median length of stay was also significantly shorter in both RDT groups compared with the control group (4.0 vs 4.1 vs 5.5 hours; P = .013). Conclusion: This study supports RDT use for bacteremia in a small community hospital with ID Telehealth support, suggesting additional benefit with RTPI.


2020 ◽  
Vol 2020 (1) ◽  
pp. 279-289
Author(s):  
Semeh Bejaoui ◽  
Michael Poulsen

Abstract Background and objectives The impact of antibiotics use early in life on later-in-life morbidities has received substantial attention as explanations for atopic and metabolic disorders with a surge as modern lifestyle diseases. The objective of this study was to perform meta-analyses to determine if antibiotics administration during the first 2 years of infant life is associated with increased risks of atopic or metabolic disorders later in life. Methodology We screened more than 100 English-language prospective and retrospective studies published between January 2002 and March 2020 and assessed study quality using the Newcastle–Ottawa scale. We performed overall and subgroup meta-analyses on 31 high-quality comparable studies on atopic and 23 on metabolic disorders, involving more than 3.5 million children. Results Antibiotic exposure prenatally and during the first 2 years of life significantly impacts the risk of developing atopic and metabolic disorders. Exposure during the first 6 months of life appears most critical, consistent with this being the time when the microbiome is most susceptible to irreversible perturbations. The presence of dose−response associations and stronger impacts of broad- than narrow-spectrum antibiotics further point to effects being mediated by microbiota-induced changes. Conclusions and implications Our findings support that antibiotics use is a mismatch to modernity that can negatively affect the symbiotic associations we rely on for proper immune function and metabolism. Improving our understanding of these associations, the underlying proximate mechanisms and the impact of antibiotics use on future human−symbiont evolution will be important to improve human health. Lay Summary The use of antibiotics in infancy has been suggested to increase the risks of atopic and metabolic disorders later in life. Through meta-analyses of more than 100 studies of &gt;3.5 million children, we confirm these risks, and show that patterns are consistent with effects being due to microbiota-driven changes.


2019 ◽  
Vol 85 (11) ◽  
pp. 1228-1233
Author(s):  
Pablo A. Baltodano ◽  
Anmol Chattha ◽  
Philip K. Johnson ◽  
Justin Kittredge ◽  
Joseph A. Ricci ◽  
...  

SSIs after ventral hernia repair (VHR) represent a significant complication. The impact of postoperative prophylactic antibiotics on the SSI rates after VHRs is unclear. A systematic review of PubMed and Web of Science databases from inception through March 2016 investigating the effect of postoperative prophylactic antibiotics after VHRs was performed. Strict inclusion and exclusion criteria were implemented, and the methodological quality of the included studies was assessed. After systematic independent assessment of 216 citations, four studies, involving 344 patients, met the inclusion criteria. Among the included studies, 164 patients received >24 hours of postoperative prophylactic antibiotics, whereas 180 patients were controls. The overall incidence of SSI among patients receiving postoperative antibiotics was 14.6 per cent (95% confidence interval [CI], 9.9 to 20.9) which compares favorably with the control group: 35.5 per cent (95% CI, 28.9 to 42.7) (odds ratio: 0.3, 95% CI: 0.2 to 0.5, P < 0.01). Among patient's receiving postoperative antibiotics, the pooled average duration of postoperative antibiotic treatment was 6.2 ± 0.4 days. Based on the available evidence, the use of postoperative prophylactic antibiotics seems to be associated with lower SSI rates after VHRs. Future prospective randomized controlled trials should be conducted to further confirm the efficacy of this prophylactic intervention.


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