Should Traditional Antimicrobial Stewardship (AMS) Models Incorporating Clinical Pharmacists with Full-Time AMS Responsibilities Be Replaced by Models in Which Pharmacists Simply Participate in AMS Activities as Part of Their Routine Ward or Team-Based Pharmaceutical Care?: THE 'PRO' SIDE

摘要

Antimicrobial stewardship (AMS) "refers to a set of coordinated strategies to improve the use of antimicrobial medications with the goal of enhancing patient health outcomes, reducing resistance to antibiotics, and decreasing unnecessary costs". Accreditation Canada requires every acute care institution to have a formal antimicrobial stewardship program (ASP). Guidelines recommend how such programs should be developed and implemented, including the role of hospital pharmacists. The provision by pharmacists of prospective audit and feedback, educational meetings and outreach, printed educational materials, and reminders about AMS-specific initiatives has been shown to improve antimicrobial utilization and prescribing appropriateness, and may also reduce super-infections, antibiotic resistance, and antimicrobial costs. However, evidence suggests that the most successful and sustainable persuasive interventions for improvement are led by clinical teams, rather than by a professional from outside the provider team, as is common in traditional ASP models.