Clinical pharmacist participation improved the cost-effectiveness of antibiotic treatment in a pediatric intensive care unit

Abstract

Based on a survey conducted by the Antibiotics Control Program of the Department of Pediatrics, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia, the use of antibiotics and evidence of antibiotic resistance in the Pediatric Intensive Care Unit (PICU) was found to be worse than average. This study aimed to evaluate the cost-effectiveness of the participation of clinical pharmacists in the PICU. A non-parallel experimental study cost-effectiveness. The study population consisted of two groups: those who received a recommendation from a clinical pharmacist (R group, n=51) and those who did not (NR group, n=42). The direct medical costs measured were the cost of the anti-bacterial agent, hospital administration, physician visits, and microbial laboratory tests. ACER and ICER were calculated using the proportion of patients with length of stay (LOS) of < = 3 days. Within the three months of the study, 120 recommendations were made. There were no significant differences in characteristics between the two groups. The effectivity of the R group (35.83%) was significantly higher than the NR group (30.26%) (p < 0.05), and the cost was also significantly lower in the R group (p < 0.05). It was also cost-saving, as shown by the ICER of the R group relative to the NR group minus IDR 395,095/effectivity-gained. Sensitivity analysis confirmed the robustness of these results. The participation of clinical pharmacists in prescription review and giving recommendations on antibiotic therapy can reduce costs and LOS of pediatric patients in PICU.