Feedback on prescribing habits can help reduce cases of C difficile
Pharmacists' feedback to doctors about their prescribing habits can help reduce cases of Clostridium difficile and increase prescribing of narrow-spectrum, rather than broad-spectrum, antibiotics, a study
published online suggests (Journal of Antimicrobial Chemotherapy, 26 March
2007).
Researchers examined the effectiveness of implementing a “narrow-spectrum
antibiotic policy” supported by a pharmacist-led
programme of audit and feedback of antibiotic use and C difficile infection
rates. Changes in use of narrow- and broad-spectrum antibiotics were
accompanied by a 65 per cent fall in C difficile infection rates (incidence
rate ratio 0.35, 95 per cent confidence interval 0.17–0.93).
Pharmacists played a crucial role in the research, Sheldon Stone, consultant
in heath care of the elderly at the Royal Free Hospital, London, and
one of the authors of the paper, told The Journal. “This research
could not have been done unless we had pharmacy time dedicated to the
study.”
Dr Stone and his colleagues were able to extend their work to the medical
admissions unit by funding a pharmacist post through the Government’s £12m
antimicrobial pharmacy initiative launched in 2003. However, Dr Stone
added: “In common with all such posts, that pump priming funding
runs out this month, and such posts need to be made permanent. Without
such investment, initiatives such as ours, which successfully reduced
Clostridium difficile-associated disease, will be harder to implement.
Primary care trusts should be required to commission an AMT [antimicrobial
pharmacist, microbiologist and part time IT] for each trust to implement
interventions such as ours.”
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