Targeting antimicrobial restriction: outcomes of pharmacist-led stewardship interventions at the university hospital Salzburg.
Purpose: Antimicrobial overuse and misuse remain critical challenges. This study examined pharmacist-led post-prescription interventions targeting restricted antimicrobials in a university hospital, identifying underlying drug-related problems (DRPs), their clinical relevance, economic impact and ch...
| Publicado en: | Infection Vol. 53; no. 6; pp. 2619 - 2633 |
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| Autores principales: | , , , , , , , |
| Formato: | algorithm research tables/charts Journal Article |
| Publicado: |
Springer Nature
Dec2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=189750512&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 189750512 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03008126 NXO jtl: Infection issn: 03008126 maglogo: N pubinfo: dt: Dec2025 vid: 53 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 189750512 186487532 189750512 189750512 10.1007/s15010-025-02604-x 189750512 ppf: 2619 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Targeting antimicrobial restriction: outcomes of pharmacist-led stewardship interventions at the university hospital Salzburg. aug: au: Past, Eva Hartmann, Laura Zimmermann, Robert Zimmermann, Georg Wallner, Markus Walter, Lisa Porsche, Ulrike Kern, Jan Marco affil: https://ror.org/05gs8cd61 Department of Clinical Pharmacy and Drug Information, Landesapotheke Salzburg, University Hospital Salzburg, Salzburg, Austria sug: subj: Antimicrobial Stewardship Methods Pharmacists Antiinfective Agents Therapeutic Use Academic Medical Centers Austria Drug Therapy Adverse Effects Clinical Competence Evaluation Cost Benefit Analysis Evaluation Drug Utilization Evaluation Treatment Outcomes Evaluation Austria Human Male Female Middle Age Aged Aged, 80 and Over Retrospective Design Nonexperimental Studies Secondary Analysis Questionnaires Random Sample Data Analysis Software Descriptive Statistics Interrater Reliability Scales Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Purpose: Antimicrobial overuse and misuse remain critical challenges. This study examined pharmacist-led post-prescription interventions targeting restricted antimicrobials in a university hospital, identifying underlying drug-related problems (DRPs), their clinical relevance, economic impact and characteristic patterns of inappropriate use. Methods: A retrospective observational analysis (January– December 2022) was conducted at the Salzburg State Hospitals using routine data of pharmacist-led interventions on restricted antimicrobials. DRPs and intervention types were categorized using validated criteria. Clinical relevance was independently assessed through an external survey, and interrater reliability was determined to ensure consistency in classification and evaluation. Potential cost savings and acceptance rates of the pharmaceutical interventions were assessed. Results: A total of 3897 restricted antimicrobial prescriptions were analyzed, with 11.7% (456) showing at least one DRP in 366 patients. The majority of DRPs (80.2%) exhibited marked clinical relevance, mainly due to non-conformance with guidelines (27.4%), unclear indication (27.2%), and the need for patient or drug monitoring (12.5%). Broad-spectrum agents linezolid (25.0%), meropenem (24.1%), ciprofloxacin (15.8%), and piperacillin-tazobactam (8.8%) accounted for nearly 74% of all DRPs. DRP-related interventions aimed at optimizing PK/PD parameters (30.6%), treatment discontinuation (28.1%), and de-escalation (17.9%). The acceptance rate of interventions was high (82.7%). A cost reduction potential was identified in 89.7% of interventions, saving €180,420 in avoided drug expenses. Conclusion: Pharmacist-led post-prescription interventions within an established AMS program effectively identified clinically relevant misuse of restricted antimicrobials. Targeted actions on key agents enable high-impact optimization, supported by strong acceptance and cost-saving potential - thereby enhancing stewardship efforts, guiding improvements in diagnostics, and prescribing behavior. pubtype: Academic Journal doctype: algorithm research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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