Impact of Clinical Pharmacist Intervention on Perioperative Antimicrobial Prophylaxis in Hysteroscopic Surgery: A Retrospective Study.

OBJECTIVE

Perioperative prophylactic antimicrobial use for hysteroscopic surgery is suboptimal, even with guidelines and official policies in place. This study aimed to assess the role of clinical pharmacists in the management of perioperative prophylactic antimicrobial therapy in hysteroscopic surgery and to analyze its impact on clinical outcomes and cost-effectiveness.

METHODS

This retrospective study reviewed hysteroscopic surgery cases at a tertiary-level Class A hospital from September to December 2022 and September to December 2023. The cases were divided into routine and intervention groups on the basis of the involvement of clinical pharmacists. The primary outcomes assessed included the rational use of antimicrobial drugs, postoperative infections, and economic benefits. To control for confounding factors, a 1:1 propensity score matching method was applied.

RESULTS

A total of 849 patients were included in this study, with 226 patients in each group after propensity score matching. Significant differences were observed between the conventional and intervention groups in several areas: unreasonable timing of preoperative drug administration (22.7% vs 0%, p < 0.001), prolonged duration of prophylaxis (32.6% vs 11.5%, p = 0.029), unindicated prophylaxis (69% vs 28.8%, p < 0.001), and inappropriate dosing regimens (61.5% vs 14.6%, p < 0.001). In terms of economic benefits, the intervention group showed a significant reduction in the length of hospitalization (3.15 vs 2.15 days, p < 0.001). Additionally, significant differences were found in the costs of patient medications ($53.17 vs $42.66, p < 0.001) and antimicrobials ($8.16 vs $2.18, p < 0.001).

CONCLUSION

Clinical pharmacist interventions can significantly enhance the rational use of perioperative antimicrobial drugs in hysteroscopic surgery, leading to notable clinical outcomes and economic benefits.