A high-performing infection prevention (IP) program will typically involve nearly every department in a hospital. In particular, the infection preventionist department must have a close working relationship with their pharmacy team. Several key aspects of robust infection prevention programs depend on the involvement and commitment of the pharmacy, especially the area of antimicrobial stewardship (AMS).
Detection and management of multidrug resistant organisms (MDROs) is central to an effective infection prevention program and involves collaboration with the pharmacy team, who may first see patterns of antibiotic overuse in attempts to prevent or shorten treatment times. The Centers for Disease Control and Prevention estimate that 30 to 50 percent of antibiotics are inappropriately prescribed in hospitals—they are either unnecessary or a poor match for the specific infection—so the involvement of pharmacy staff can have significant payoffs in terms of treatment costs and quality .
Pharmacists are often also instrumental in creating a facility-specific antibiogram, which identifies antibiotic resistance patterns and can help with proper selection of therapies. For hospitals with automated infection prevention systems, the pharmacy team can provide valuable input and help to interpret the antibiogram created from data collected by the IP system. The majority of nearly 99,000 deaths from healthcare acquired infections (HAIs) in the United States each year are attributed to antibiotic-resistant pathogens, especially methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). The importance of the pharmacy’s role in an infection prevention program cannot be overstated .
Pharmacists can also help match patients prescribed antibiotics to microbiology results to ensure the best possible bug/drug match and reduce morbidity and mortality. Automated systems can help by providing real-time lab results and alerts, particularly for sentinel organisms. Such systems can also alert pharmacists to contact a physician regarding a patient’s need for antimicrobial therapy, dosage adjustments or second-line treatments. Pharmacists can assume a critical role in development of treatment guidelines to choose effective first-line therapies and subsequent selections, if necessary, to improve patient outcomes.
On a broader basis, pharmacists make valuable contributions to the interdisciplinary committees that develop and implement processes and protocols. For example, they can advise on current recommendations for the use of prophylactic antibiotics in surgery and ensure that the right drugs are conveniently available in the right dose and frequency. Pharmacists can also assist the infection prevention team with revisions to guidelines for antimicrobial use based on the latest research and recommendations from national organizations.
How has a relationship between your IP and pharmacy teams benefited your hospital? Please leave comments below.
Centers for Disease Control and Prevention. http://www.cdc.gov/getsmart/healthcare/
American Public Health Association. Prevention and Control of Multidrug-Resistant Organisms. Policy number: 200717. November 6, 2007. http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1365