The impact of pharmacist behavioral intervention on antibiotics prescribing in pediatric wards

Abstract

Background: Antibiotics may be prescribed irrationally, which can lead to significant consequences including the emergence of antimicrobial resistance. Pharmacists can play a key role in enhancing the rational antibiotic prescribing. This study aimed to evaluate the current clinical practice of prescribing antimicrobial agents in pediatric wards and to assess the clinical and economic impact of pharmacist interventions on antibiotic prescribing. Methodology: This study was conducted at the pediatric wards of a general hospital, Babel, Iraq. The study population included all pediatric inpatients aged ≤ 12 years and receiving antibiotic. The study consisted of three phases. The first was a pre-intervention phase where data about antibiotic prescription was collected retrospectively. The second phase involved pharmacist intervention where the researcher had provided an oral presentation to the healthcare workers. The third phase involved prospective data collection which was compared with the pre-intervention data. Independent T-test was used to compare the differences in the parameters between the pre-and post-intervention phases. Results: The study included 250 children in each of the pre- and post-intervention phases who received antibiotic treatment. The medical records were reviewed retrospectively. Four antibiotics (amoxicillin, cefotaxime, vancomycin and meropenem) were significantly less frequently used in the post-intervention phase. Single antibiotic treatment was significantly higher in the post-intervention phase (p-value<0.05). Length and days of therapy, and the total cost of the antibiotics used were significantly lower in the post-intervention phase. Culture and sensitivity tests were performed only in 28% of patients in the post-intervention phase where the isolated bacteria were found to be highly resistant to penicillin and cephalosporin. Conclusions: This study demonstrated that pharmacist intervention in general pediatric wards has resulted in favorable clinical and economic outcomes. This emphasizes the essential role pharmacists can play in rational antibiotic use, not only in the pediatric population but also in the adults.