LAUSR

INTRODUCTION This study was designed to evaluate the sustainability of the impact of educational programs provided by pharmacists on the appropriateness of surgical antibiotic prophylaxis and cost-savings in a short time and a long time after the intervention. METHODS AND MATERIALS This prospective educational interventional study was conducted in a tertiary referral hospital for surgery in the West of Iran from September 2018 to October 2019. The study was designed in three phases: pre-intervention phase, short term after the intervention, and six months after the intervention. Within a one month course, several educational sessions regarding the appropriate preoperative antibiotic prophylaxis based on the recommendations of the American Society of Health-System Pharmacists guideline (ASHPs) were provided by a clinical pharmacist in an interactive manner for the surgeons. The appropriateness of antibiotic prophylaxis regarding the necessity for surgical antibiotic prophylaxis use (indication), the choice of antibiotic, the timing of antibiotic administration, the route of administration, the dose of antibiotics, and the total duration of antibiotic prophylaxis was evaluated and compared before and after the educational intervention. Additionally, medication-related costs, non-medication-related costs, antibiotic prophylaxis-related costs, and total costs of care were also assessed before and after the educational intervention. RESULTS Our survey showed that total adherence to the guideline recommendations among surgeons in our center was relatively low, and in 71.8% of procedures, at least in one of the quality indicators, non-adherence to the guideline recommendations was observed. After the educational intervention, a significant improvement in the rationality of antibiotic prophylaxis, in terms of not administrating antibiotic prophylaxis in procedures without indication, appropriate timing of administration, appropriate antibiotic dose, and appropriate duration of antibiotic prophylaxis, especially in the short time after the intervention was observed that ultimately reduced the medication, non-medication, antibiotic prophylaxis related, and total therapeutic costs. CONCLUSIONS Our survey showed that educational interventions provided by pharmacists in an interactive manner could improve guideline recommendations' adherence among surgeons, particularly in a short time. Thus, continuous education still should be considered as an essential element of a multifaceted intervention for improving guideline adherence.