title: Impact of the pharmacist on a multidisciplinary team in an antimicrobial stewardship program: a quasi-experimental study.
abstract: BACKGROUND
  Antimicrobial stewardship programs (ASP) have been implemented to promote rational use of antimicrobial drugs. Multidisciplinary teams are needed to form effective committees.
  
  
  OBJECTIVE
  Assess the impact of ASP, with and without the presence of a pharmacist, in a cardiology hospital in Brazil.
  
  
  METHODS
  The program started with an infectious disease (ID) physician, and after 22 months, a pharmacist started to work in the ASP team. We present data related to: stage 1-before the program implementation; stage 2-with the ID physician; and stage 3 with the inclusion of a pharmacist. Analysis was made by segmented regression of time series.
  
  
  RESULTS
  After the start of ASP there was a significant reduction of consumption of all antimicrobials. The pharmacist contributed to the significant reduction in consumption of fluoroquinolones, clindamycin and ampicillin/sulbactam and in increase in total cephalosporins use in stage 3. Adherence rate to the ASP team recommendations was 64.1%. There was a significant reduction of 69% in hospital antibiotics costs.
  
  
  CONCLUSIONS
  A non-expensive ASP in a limited resource country resulted in reductions in antimicrobial consumption and costs. The multidisciplinary team contributed to maximize the impact of interventions.
authors.affiliation: Hospital Infection Control Service, Instituto de Cardiologia Fundação, Universitária de Cardiologia de Porto Alegre, Porto Alegre, Brazil. lmagedanz@gmail.com
authors.forename: Lucas
authors.initials: L
authors.lastname: Magedanz
authors.forename: Erci Maria
authors.initials: EM
authors.lastname: Silliprandi
authors.forename: Rodrigo Pires
authors.initials: RP
authors.lastname: dos Santos
mesh_terms: D000890:Anti-Infective Agents / Q000191:economics / Q000627:therapeutic use*; D001938:Brazil; D016009:Chi-Square Distribution; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D016527:Drug Costs; D004363:Drug Utilization; D017723:Drug Utilization Review; D019983:Guideline Adherence; D017721:Hospital Costs; D006801:Humans; D033183:Interdisciplinary Communication; D009937:Organizational Objectives; D010348:Patient Care Team / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D010595:Pharmacists / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D010607:Pharmacy Service, Hospital / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D015397:Program Evaluation; D011446:Prospective Studies; D012044:Regression Analysis; D013997:Time Factors
chemical_list: D000890:Anti-Infective Agents