2019 年 45 巻 8 号 p. 460-469
In Kobe University Hospital, we have been conducting case conferences once a week to investigate the adequacy of administration of broad-spectrum antibiotics to ensure their appropriate use. However, immediate interventions were not implemented except for cases with positive blood culture results. Therefore, as a part of the newly-launched Antimicrobial Stewardship Team, a full-time pharmacist started monitoring the use of broad-spectrum antimicrobials early and conducted lectures on the appropriate use of antibiotics for hospital staff. The purpose of this study was to assess the impact of full-time pharmacist interventions on antimicrobial stewardship, in addition to the existing support activities. During the intervention period from May 2018 to February 2019, the full-time pharmacist provided advice on early monitoring for 149 cases and the change rate based on the advice was 81.2％. Lectures for hospital staff were conducted six times during the intervention period. Additionally, as compared to the period from May 2017 to February 2018, that is, before the intervention, the days of therapy (DOTs) for antipseudomonal agents significantly decreased from 56.0 to 47.7 during the intervention period (P = 0.004). Furthermore, the cost of all injectable antibiotics decreased by an estimated 8.24 million yen, reflecting a decrease in the use of antipseudomonal agents. These findings suggest that, in addition to the existing support activities, the implementation of aggressive interventions by full-time pharmacists is useful not only for promoting the appropriate use of antibiotics but is also important from the perspective of medical economics.
