Enhancing antimicrobial stewardship program: impact of clinical pharmacist-driven feedback in the absence of infectious diseases physicians-a multicenter quasi-experimental study.

Objective: To evaluate the impact of clinical pharmacist-driven feedback on Antimicrobial Stewardship Program (AMSP) in the absence of infectious disease physicians across three different geographic locations. Design: Multicenter quasi-experimental study. Setting: Three private tertiary referral centers in different geographical locations in India. Participants: All consecutive prescriptions with restricted antibiotics for inpatients during the study period. Intervention: This study was conducted over 15 months from June 2022 to May 2023. The impact of mentoring clinical pharmacists by infectious disease physicians, enhancing their communication abilities for providing proactive feedback, and the impact on prescription practice were measured in terms of new prescriptions of restricted antibiotics, compliance to clinical pharmacist advice, and the duration of restricted antibiotic therapy usage, measured in terms of days of therapy (DOT) of restricted antibiotics. Gross mortality was reviewed as a balancing measure, and dose/dosing errors were considered as a secondary outcome. Data were captured in Microsoft Excel and analyzed using the SPSS software. Results: Clinical pharmacist-led antimicrobial stewardship interventions were found to have a significant impact on decreasing antibiotic prescriptions, increasing healthcare organization policy compliance, and decreasing DOT for restricted antibiotics. Culture sampling, acceptance of antimicrobial stewardship advice, dosing errors, or mortality rates were not statistically significantly related to the other study parameters. Conclusion: Clinical pharmacist-driven AMSP can be effectively implemented irrespective of the cultural and geographical setting due to their ability to improve prescription practices.