Roles of Pharmacists in Promoting the Appropriate Use of Perioperative Antimicrobials

Abstract

Pharmacists at our institution play an active role in promoting the appropriate use of perioperative antimicrobials through participation in the infection control team (ICT), antimicrobial stewardship team (AST), and ward-based clinical services.

Previously, each clinical department independently selected perioperative antimicrobials, and antimicrobial stewardship activities were conducted separately by AST members and ward pharmacists without systematic collaboration. ICT members have been involved in the development and review of clinical pathways since April 2021, resulting in the approval of only those pathways that employ guideline-concordant prophylactic antimicrobial regimens.

Within the AST, pharmacists collaborate with ward-based pharmacists by sharing information on antimicrobials administered to patients, thereby supporting antimicrobial stewardship activities.

Ward pharmacists are responsible for collecting relevant patient information, including antimicrobial allergy histories, providing explanations regarding perioperative antimicrobial therapy, and implementing patient-specific interventions, such as body weight-based dose adjustments and re-dosing interval modifications according to renal function.

A structured feedback sheet system was established between the AST and ward pharmacists to enhance the efficiency of these collaborative activities, facilitating timely information sharing and strengthening interprofessional coordination.

In addition, clinical pathways are applied to nearly all scheduled surgical procedures in our hospital, facilitating the selection of guideline-concordant prophylactic antimicrobials and their administration at appropriate patient-specific doses and intervals.

Furthermore, deviations from the clinical pathways can be identified and addressed by systematic sharing of information on antimicrobials used for postoperative patients, thereby ensuring the effective implementation of antimicrobial use as defined by the pathways. Effective communication between pharmacists and other healthcare team members is critical to ensure the appropriate and effective use of perioperative antimicrobial agents.