Potential Impact of the Involvement of Clinical Pharmacists in Antimicrobial Stewardship Programs on the Incidence of Antimicrobial-Related Adverse Events in Hospitalized Patients: A Multicenter Retrospective Study
Yewon Suh,
Young-Mi Ah,
Ha-Jin Chun,
Su-Mi Lee,
Hyung-sook Kim,
Hyun-Jun Gu,
A-Jeong Kim,
Jee-Eun Chung,
Yoonsook Cho,
Young-Hee Lee,
Shin-Yi Hwangbo,
Jeongmee Kim,
Eu-Suk Kim,
Hong-Bin Kim,
Eunsook Lee,
Ju-Yeun Lee
Affiliations
Yewon Suh
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Korea
Young-Mi Ah
College of Pharmacy, Yeungnam University, Gyeongsan 38541, Korea
Ha-Jin Chun
Department of Pharmacy, Ajou University Medical Center, Suwon 16499, Korea
Su-Mi Lee
Department of Pharmacy, Samsung Medical Center, Seoul 06351, Korea
Hyung-sook Kim
Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam 13620, Korea
Hyun-Jun Gu
Department of Pharmacy, The Catholic University of Korea Seoul ST. Mary’s Hospital, Seoul 06591, Korea
A-Jeong Kim
Department of Pharmacy, Seoul National University Hospital, Seoul 03080, Korea
Jee-Eun Chung
College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan 15588, Korea
Yoonsook Cho
Department of Pharmacy, Seoul National University Hospital, Seoul 03080, Korea
Young-Hee Lee
Department of Pharmacy, Ajou University Medical Center, Suwon 16499, Korea
Shin-Yi Hwangbo
Department of Pharmacy, The Catholic University of Korea Seoul ST. Mary’s Hospital, Seoul 06591, Korea
Jeongmee Kim
Department of Pharmacy, Samsung Medical Center, Seoul 06351, Korea
Eu-Suk Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
Hong-Bin Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
Eunsook Lee
Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam 13620, Korea
Ju-Yeun Lee
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Korea
Although specialized pharmacists have been suggested to be essential members of antimicrobial stewardship programs (ASPs), not all hospitals in Korea operate ASPs with pharmacists involved. We aimed to evaluate the association of involvement of clinical pharmacists as team members of multidisciplinary ASPs with the incidence of antimicrobial-related adverse drug events (ADEs). Five tertiary teaching hospitals participated in this retrospective cohort study. At each participating hospital, we randomly selected 1000 participants among patients who had received systemic antimicrobial agents for more than one day during the first quarter of 2017. We investigated five categories of antimicrobial-related ADEs: allergic reactions, hematologic toxicity, nephrotoxicity, hepatotoxicity, and antimicrobial-related diarrhea. Multivariate logistic regression analysis was used to evaluate the potential impact of pharmacist involvement in ASPs on the incidence of ADEs. A total of 1195 antimicrobial-related ADEs occurred in 618 (12.4%) of the 4995 patients included in the analysis. The overall rate of ADE occurrence was 17.4 per 1000 patient days. Hospitals operating ASPs with pharmacists showed significantly lower AE incidence proportions than other hospitals (8.9% vs. 14.7%; p < 0.001). Multidisciplinary ASPs that included clinical pharmacists reduced the risk of antimicrobial-related ADEs by 38% (adjusted odds ratio 0.62; 95% confidence interval 0.50–0.77). Our results suggest that the active involvement of clinical pharmacists in multidisciplinary ASPs may contribute to reduce the incidence of antimicrobial-related ADEs in hospitalized patients.