Aysel PEHLİVANLI, Tuğba YANIK YALÇIN, Fatma İrem YEŞİLER, Nuran SARI, Helin ŞAHİNTÜRK, Özlem Kurt AZAP, Pınar ZEYNELOĞLU, Bilgen BAŞGUT
Türk Yoğun Bakım Dergisi - 2026;24(3):165-172
Objective: This study aims to assess the frequency of drug-related problems (DRPs) related to antimicrobial drugs in the ICU and to examine changes in the use of antibiotics in the 'Reserve' group of the World Health Organization (WHO) AWaRe classification during the antimicrobial stewardship (AMS) team intervention, including the clinical pharmacist. Methods: In this single-center intervention study, the pre-intervention period between November 2021 and August 2022 and the post-intervention period between November 2022 and August 2023 were evaluated. In the post-intervention period, a clinical pharmacist was also included in the AMS team. Post-intervention medication-related problems (DRPs) were categorized using only the "problem" and "cause" domains of the Pharmaceutical Care Network Europe (PCNE) V9.1 classification system. Additionally, recommendations and their acceptance rates were recorded. The antibiotic use density of the 'Reserve' group, defined in the WHO AWaRe classification, was evaluated in terms of days of therapy (DOT) per 1000 patient-days. Results: After the intervention, 175 DRPs were detected in 67.1% of 173 patients; 70% were related to antimicrobial drugs. The 90.1% of the interventions suggested by the clinical pharmacist were evaluated and accepted by infectious diseases and intensive care specialists. The total use of "Reserve" group antibiotics decreased, but not significantly; significant decreases were observed for some agents such as linezolid and daptomycin. Conclusion: Multidisciplinary antimicrobial stewardship practices involving the clinical pharmacist can contribute to the prevention of antimicrobial resistance development by facilitating the detection and solution of DRPs, especially by reducing the use of 'Reserve' group antimicrobials.
