Efforts and Effects to Improve the Rate of Bacterial Culture Submission before Using Broad-spectrum Antimicrobial Agents by the Full-time Pharmacist

• Published in: Japanese Journal of Infection Prevention and Control Vol. 39; no. 6; pp. 215 - 220
• Main Authors: TAKADA, Masahiro, SUDO, Takeshi, HOSHIKAWA, Kanami, MAEDA, Ryuto, YOSHINO, Hiroe, SHINGAI, Mika
• Format: Journal Article
• Language: English; Japanese
• Published: Japanese Society for Infection Prevention and Control 25.11.2024
• Subjects: broad-spectrum antimicrobial agents; full-time pharmacist; improved rate of bacterial culture submission; initial therapy; piperacillin/tazobactam
• ISSN: 1882-532X; 1883-2407
• DOI: 10.4058/jsei.39.215

The National Hospital Organization Kure Medical Center has a full-time pharmacist and has been practicing the proper use of carbapenem; however, the rate of bacterial culture submission before using broad-spectrum antimicrobial agents, mainly piperacillin/tazobactam (PIPC/TAZ), has been low. This single-center cohort study compared the rate of bacterial culture submission before and after efforts to improve the rate before using broad-spectrum antimicrobial agents in patients admitted to our hospital. The rate of bacterial culture submission significantly increased from 74% to 90% (p < 0.05), the number of AST suggestions per 1000 admissions significantly increased from 3.0 to 4.1 (p < 0.05), and the number of days of therapy (DOTs/1000 patient-days) for PIPC/TAZ significantly decreased from 44 to 35 (p < 0.05). The use of PIPC/TAZ (from 37% to 21%) significantly decreased, whereas that of narrow-spectrum antibacterial agents cefmetazole (CMZ: from 6% to 15%) significantly increased in patients with initial therapy for bacteremia (p < 0.05). The 30-day mortality rate of patients with bacteremia did not change from 7.3% (18/248 patients) to 8.6% (26/302 patients). We believe that efforts to improve the rate of bacterial culture submission before using broad-spectrum antimicrobial agents increase the submission rate, increase active intervention by the full-time pharmacist, and preserve PIPC/TAZ after initial therapy without worsening the outcome measures.