Antimicrobial prescribing in a regional hospital: impact of collaboration with a new on-site pharmacy service

Mrs Mahsa Tantiongco1,2, Dr Pascale Dettwiller1

1SA Pharmacy, Port Lincoln, Australia, 2University of South Australia, Adelaide, Australia


There are many well-evidenced barriers to effective establishment of Antimicrobial Stewardship (AMS) Programs in rural and remote hospitals. Pharmacist involvement in AMS programs has been recommended as a component of a multidisciplinary approach to promote appropriate antimicrobial prescribing. This study aims at describing the impact of clinical pharmacy services on antimicrobial prescribing at a regional GP-led hospital in Port Lincoln, South Australia and to explore areas of suboptimal antibiotic prescribing for further improvement.


A retrospective cross-sectional audit of patient medical records was conducted for antimicrobial prescriptions in all adult patients who had presented with sepsis, cellulitis, urinary tract infections and pneumonia between May and August 2015 and repeated for same time period in 2018. Appropriateness of therapy was assessed using the National Antimicrobial Prescribing Survey guidelines.


A total of 115 antibiotic orders from 2015 and 158 orders from 2018 were included in the analysis. There were no statistically and clinically significant differences in baseline characteristics between the two groups. 86% of patients (55/64) in the post intervention group were reviewed by a clinical pharmacist during their admission. Appropriate therapy was increased from 66/115 (57%) in 2015 to 129/158 (82%) in 2018 (p=0.0013). Cost of antimicrobial therapy per patient day was halved from $10 to $5.33, pre and post introduction of clinical pharmacy service respectively.


This study demonstrates a significant improvement in antibiotic prescribing post implementation of a clinical pharmacy service in a small rural GP led hospital and the cost benefit of AMS.


Mahsa Tantiongco holds a Bachelor of Pharmacy from UNISA. She has recently completed an 18 month secondment as a Senior Pharmacist at Port Lincoln Hospital. Prior to this she was working at Flinders Medical Centre for 10 years in various rotational and specialist clinical roles. Mahsa has a keen interest in improving patient care and medication safety. She is currently completing her Masters of Clinical Pharmacy through the University of South Australia studying Antimicrobial Stewardship in a rural setting.

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