title: Impact of pharmacist interventions on rational prophylactic antibiotic use and cost saving in elective cesarean section.
abstract: OBJECTIVE
  To assess the impact of pharmacist interventions on rational use of prophylactic antibiotics and cost saving in elective cesarean section and the economic outcomes of implementing pharmacist interventions.
  
  
  METHODS
  A pre-to-post intervention design was applied to the practices of prophylactic antibiotic use in the department of gynecology and obstetrics in a Chinese tertiary hospital. Patients admitted during a 3-month period from June to August 2012 and during that from October to December 2012 undergoing elective cesarean section were assigned to the pre-intervention and the post-intervention group, respectively. Pharmacist interventions were performed in the post-intervention group, including obstetrician education, realtime monitoring of clinical records and making recommendations to obstetricians on prophylactic antibiotic prescription based on the criteria set at the beginning of the study. Data from the two groups were then compared to evaluate the outcomes of pharmacist interventions. Cost-outcome analysis was performed to determine the economic effect of implementing pharmacist interventions in preoperative antibiotic prophylaxis.
  
  
  RESULTS
  Pharmacist interventions led to significant reductions in antibiotic usage cost/patient-day (p < 0.001), mean antibiotic cost (p < 0.001), mean total drug cost (p < 0.001), mean total hospitalization cost (p < 0.001), the duration of prophylaxis antibiotics (p < 0.001) and a significant increase by 19.29% in the percentage of cases adhering to all of the four criteria (p < 0.001). The ratio of the saving in antibiotic use to the cost of pharmacist time was 27.23 : 1 and the net cost benefit was $65,255.84.
  
  
  CONCLUSIONS
  This study provides evidence that pharmacist interventions promoted rational use of prophylactic antibiotics and substantial cost saving in elective cesarean section.
authors.forename: Jingwen
authors.initials: J
authors.lastname: Wang
authors.forename: Mohan
authors.initials: M
authors.lastname: Dong
authors.forename: Yang
authors.initials: Y
authors.lastname: Lu
authors.forename: Xian
authors.initials: X
authors.lastname: Zhao
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.forename: Aidong
authors.initials: A
authors.lastname: Wen
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics*; D019072:Antibiotic Prophylaxis / Q000191:economics*; D002585:Cesarean Section / Q000009:adverse effects / Q000191:economics*; D002681:China; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D016527:Drug Costs; D017558:Elective Surgical Procedures; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008508:Medication Errors / Q000191:economics / Q000517:prevention & control; D018803:Models, Economic; D010348:Patient Care Team / Q000191:economics; D010595:Pharmacists / Q000191:economics*; D010607:Pharmacy Service, Hospital / Q000191:economics*; D010865:Pilot Projects; D011247:Pregnancy; D017064:Process Assessment, Health Care / Q000191:economics*; D024382:Professional Role; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000191:economics* / Q000382:microbiology / Q000517:prevention & control*; D062606:Tertiary Care Centers / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents