BACKGROUND Antimicrobial misuse leading to drug resistance is a growing concern for clinicians. Improving antimicrobial stewardship programmes through development of new tools could be part of the solution. AIM To evaluate antimicrobial use in hospitalized patients after implementation of an antimicrobial checklist for ward-based clinical pharmacists. METHODS A checklist based on quality indicators of optimal antimicrobial use was implemented to standardize hospital pharmacists' assessments of antimicrobial therapy. Antimicrobial use metrics from adults hospitalized during the control and intervention periods were assessed in an interrupted time series analysis of individual patient data. The primary endpoint was days of therapy (DOT) for all antimicrobials per 1000 days present for included patients. Secondary endpoints were the DOT of extended-spectrum antimicrobials (DOT-ES), length of therapy of all antimicrobials (LOT) and the number of pharmacist interventions. FINDINGS One-thousand six-hundred and nineteen patients were included: 800 and 819 in the pre- and post-checklist implementation periods, respectively. As indicated by the point estimates and their 95% confidence intervals (CIs), there were no changes in trend for DOT, DOT-ES or LOT. A change in level was not found for the DOT, while a change of -118 DOT-ES [-209,-28] and -51 LOT [-97,-4] was documented. Furthermore, pharmacists' interventions regarding antimicrobials increased by 18.7% (14.0, 23.5) and progress notes by 32.3% (27.8, 36.8). CONCLUSION An antimicrobial checklist used by ward-based clinical pharmacists did not decrease DOT for all antimicrobials, but decreased DOT-ES and LOT upon its implementation.

中文翻译：

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药剂师使用的检查表对医院抗菌药物使用的影响：一项患者水平的中断时间序列研究。

背景技术导致耐药性的抗生素滥用是临床医生日益关注的问题。通过开发新工具来改善抗菌素管理计划可能是解决方案的一部分。目的评估针对病房的临床药剂师实施的抗菌检查清单后，在住院患者中使用抗菌药物的情况。方法实施了基于最佳抗菌药物使用质量指标的清单，以标准化医院药剂师对抗菌药物治疗的评估。在对各个患者数据进行中断的时间序列分析中，评估了在对照和干预期间住院的成年人的抗菌药物使用指标。主要终点是所包括的患者每1000天对所有抗菌药物的治疗天数（DOT）。次要终点是大范围抗菌药物（DOT-ES）的DOT，所有抗菌药物的治疗时间（LOT）以及药剂师干预的次数。研究结果包括1.06万名患者和19.90名患者：在实施清单前和实施后分别为800名和819名患者。如点估计及其95％置信区间（CI）所示，DOT，DOT-ES或LOT的趋势没有变化。没有发现DOT的水平变化，而记录了-118 DOT-ES [-209，-28]和-51 LOT [-97，-4]的变化。此外，药剂师在抗菌药物方面的干预措施增加了18.7％（14.0，23.5），进度说明增加了32.3％（27.8，36.8）。结论基于病房的临床药剂师使用的抗菌检查清单并未降低所有抗菌药物的DOT，