Effect of clinical pharmacists in the antimicrobial management: a systematic review and meta-analysis

Objective To investigate the effectiveness of pharmacists' interventions on antibiotic use, so as to provide reference for the development of pharmaceutical care by clinical pharmacists. Methods We searched PubMed, the Cochrane Library, Embase, CNKI, Wanfang, VIP, CBM to June in 2017 for RCTs about pharmacists' interventions on antimicrobial management. Relevant data and carried out risk-of-bias assessments were extracted by two reviewers working independently. The Meta analysis was performed by using RevMan 5.3 software. Results Total 8 RCTs involving 2 737 patients were analyzed. The meta-analysis indicated that the pharmacists' intervention teams may shorten length of hospitalization[WMD=-1.96, 95% CI(-3.39, -0.52), P=0.007], improve the proportion of appropriate antimicrobial prescriptions[RR=2.09, 95% CI(1.15, 3.79), P=0.021], reduce the cost of antibiotics[WMD=-125.51, 95% CI(-172.49, -78.52), P<0.001], compared with the control teams. But there was no significant difference in the duration of antibiotics therapy between the two teams[WMD=-1.3, 95% CI(-2.77, 0.17),P=0.082]. Conclusion pharmacists' intervention may significantly shorten length of hospitalization, improve the proportion of appropriate antimicrobial prescriptions, and reduce the cost of antibiotics.