Evaluation of Clinical Pharmacist's Contribution to Sepsis and Septic
Shock Management
Abstract
Purpose: This study aimed to identify drug-related problems at treatment
in patients with sepsis and septic shock and to evaluate the
contribution of the clinical pharmacist. Methods: This study was
conducted at intensive care units(ICU) of a university hospital. A study
group in which the clinical pharmacist participated in the treatment
management of septic patients and a control group in which the clinic
did not have a pharmacist was formed. In the treatment of the control
group, interventions were made for drug-related problems detected by the
clinical pharmacist. Study and control group were compared in terms of
length of ICU stay, time to initiation of appropriate antimicrobial
drug(s), appropriateness of antimicrobial dosing, and drug treatment
costs. Results: Total of 65 patients were included in the study group
prospectively in which the intervention of clinical pharmacist provided
for the drug treatments and retrospectively 65 patients in the control
group without any intervention. In the study group, 670 recommendations
were made for 753 problems related to their drug therapy. Between
groups, improvement in appropriateness of antimicrobials in terms of
dose, time to initiation of appropriate antimicrobial therapy, daily
antibiotic costs in all patients and antibiotic costs in patients with
impaired renal function statistically significant difference were found.
Conclusions: As a result of clinical pharmacist involvement in sepsis
management, it has been shown to contribute to the prevention and
management of drug interactions, to start antimicrobial therapies more
quickly, to select the appropriate drug and dose, especially
antimicrobials, and to save the costs of antimicrobial drugs.