A systematic review and meta-analysis: the effect of pharmacist-led antibiotic stewardship programs on antibiotic consumption and rational use

Irrational use of antibiotics and antibiotic resistance are one of the major problems encountered in healthcare services. Antibiotic stewardship programs (ASPs) have been one of the most successful attempts in hospitals to control antibiotic resistance. Pharmacists are the core health professionals in ASPs. This study aimed to examine the effect of clinical pharmacist-led ASPs on antibiotic consumption with meta-analysis. ScienceDirect, PubMed, MEDLINE and Cochrane databases were searched for relevant studies. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline was used to identify studies for the review. Methodological quality was assessed using Newcastle-Ottawa scale (NOS) and National Heart, Lung and Blood Institute (NHLBI) pre-post comparison studies quality tool. The R (version 4.0.3.) and metafor packages (version 2.1-0) were used for a random-effects meta-analysis. After pharmacist intervention, the pooled rational use of antibiotics was determined as 0.28 (28% improvement, I²=98.26; 95% CI 0.15-0.41). The pooled duration of therapy data was determined as 0.41 (41% reduction, I²=96.30%; 95% CI 0.54-0.29) in favor of the group with the pharmacist’s intervention. As a result of this study, it was determined that clinical pharmacists took part in the evaluation of the patient, regulation of the treatment, follow-up of the patient after treatment, and education in ASPs. These findings can contribute to improving the role of the pharmacist in ASPs and rational antibiotic use, thereby controlling antibiotic resistance.